SEARCH Initial Participant Survey - Prevalence

SEARCH for Diabetes in Youth Study

Documents and Forms

Document Name Document Type
SEARCH Initial Participant Survey - Prevalence Form
Initial Participant Survey - Adult Prevalent Case Attachment 4A5_Initial Participant Survey_Prevalent case_adult r102017.pdf Form
Initial Participant Survey - Child Prevalent Case Attachment 4A6_Initial Participant Survey_Prevalent case_child r102017.pdf Form

Information Collection (IC) Details

IC Title:	SEARCH Initial Participant Survey - Prevalence	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	n/a	Initial Participant Survey - Adult Prevalent Case	Attachment 4A5_Initial Participant Survey_Prevalent case_adult r102017.pdf		No		Paper Only
Form	n/a	Initial Participant Survey - Child Prevalent Case	Attachment 4A6_Initial Participant Survey_Prevalent case_child r102017.pdf		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 776	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	776	776
Annual IC Time Burden (Hours)	129	129
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.