APPENDIX I:
FPRQ Cognitive Interviews – Individual Sign-Up Sheet
October 24, 2013
Individual Sign-Up Sheet
Sign up here to get more information about a study on relationships between families and Family Service Workers. Your information will remain private to the extent permitted by law.
Name: ___________________________________________
Home Phone Number: ______________________________
Cell Phone Number: ________________________________
Email: ____________________________________________
Best Time to Reach You: ____________________________
Please hand your completed sign-up sheet to _______________.
The Paperwork Reduction Act Statement: This collection of information is voluntary and will be used to help develop questions for surveys about relationships between Family Service Workers (FSWs) and the families they work with. Public reporting burden for this collection of information is estimated to average 2.25 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this collection is 0970-0355 and it expires 01/31/2015.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | KPeterson |
| File Modified | 0000-00-00 |
| File Created | 2021-01-27 |