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FASD Core Training Survey - Post-test
Improving Fetal Alcohol Spectrum Disorders Prevention and Practice through Practice and Implementation Centers and National Partnerships
OMB: 0920-1129
IC ID: 220377
OMB.report
HHS/CDC
OMB 0920-1129
ICR 201707-0920-006
IC 220377
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1129 can be found here:
2021-02-08 - Reinstatement without change of a previously approved collection
Documents and Forms
Document Name
Document Type
FASD Core Training Survey - Post-test
Form
FASD Post-training survey
N2 Core Post-Training Survey Screenshots.pdf
Form
D2 Core Post-Training Survey .docx
FASD Training Survey - Post-test - word
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
FASD Core Training Survey - Post-test
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
none
FASD Post-training survey
N2 Core Post-Training Survey Screenshots.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,013
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
4,013
0
0
0
0
4,013
Annual IC Time Burden (Hours)
334
0
0
0
0
334
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
FASD Training Survey - Post-test - word
D2 Core Post-Training Survey .docx
03/02/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.