0920-1235 Sample Instrument: Parent/Caregiver Survey

Assessments to Inform Program Refinement for HIV, other STD, and Pregnancy Prevention among Middle and High-School Aged Youth

Att 6-Sample Instrument-Parent-Caregiver Survey

Sample Instrument: Parent Interview/Focus Group Guide

OMB: 0920-1235

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-1235 can be found here:
2023-05-04 - No material or nonsubstantive change to a currently approved collection
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