Youth survey for proof-of-concept study

Sexual Risk Avoidance Education (SRAE) National Evaluation Overarching Generic

Documents and Forms

Document Name Document Type
Instrument 1a. Youth Survey (Proof of Concept).docx Other-Survey
SRAENE_Generic_SSA 05.20.2025.docx SSA - Umbrella Generic and Initial GenIC: Proof-of-Concept NativeSTAND IC Document
SRAENE_Generic_SSB 05.20.2025.docx SSB - Umbrella Generic and Initial GenIC: Proof-of-Concept NativeSTAND IC Document
Appendix A1 Proof-of-concept study consent and assent forms.docx Appendix A1: Proof-of-concept study consent and assent forms IC Document

Information Collection (IC) Details

IC Title:	Youth survey for proof-of-concept study	Agency IC Tracking Number:

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
Other-Survey			Instrument 1a. Youth Survey (Proof of Concept).docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA - Umbrella Generic and Initial GenIC: Proof-of-Concept NativeSTAND	SRAENE_Generic_SSA 05.20.2025.docx	05/22/2025
SSB - Umbrella Generic and Initial GenIC: Proof-of-Concept NativeSTAND	SRAENE_Generic_SSB 05.20.2025.docx	05/22/2025
Appendix A1: Proof-of-concept study consent and assent forms	Appendix A1 Proof-of-concept study consent and assent forms.docx	05/22/2025

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