Baseline survey & Identifying and contact information –staff

Instrument 2. Identifying and contact information

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is XXXX-XXXX. The time required to complete this information collection is estimated to average 25 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. This includes the time it takes to complete the baseline survey. Send comments regarding this burden estimate to XXX. OMB expiration date xx/xx/xxxx.

Identifying and Contact Information Data Collection - Screens in the Random Assignment, Participant Tracking Enrollment, and Reporting, or RAPTER®, system

A1. Login screens

Intake Screens

B1. Study Eligibility

B2. Consent by Sample Member

B3. Consent by parent/guardian

B4. Applicant information

B5. Duplicate check

B6. Baseline

B7. Additional contacts screen

B8. Enrollment complete