Children's Heart Health Promotion Tracker

Parental Knowledge, Attitudes, and Behaviors Related to Pediatric Cardiovascular Health

Documents and Forms

Document Name Document Type
Form 2 Children's Heart Health Promotion Tracker Form and Instruction
2 Screener NHLBI Attachment 4 - Screener Instrument.docx Form and Instruction
1 Survey NHLBI Attachment 1 - Survey Instrument.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Children's Heart Health Promotion Tracker	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 and Instruction	2	Screener	NHLBI Attachment 4 - Screener Instrument.docx		Yes	Yes	Paper Only
Form and Instruction	1	Survey	NHLBI Attachment 1 - Survey Instrument.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,175	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,175	1,175
Annual IC Time Burden (Hours)	196	196
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.