Strategies To Respond to Intimate Violence Effectively (STRIVE)

Formative Data Collections for ACF Program Support

Documents and Forms

Document Name Document Type
Instrument 1. HMRE pre and post survey.docx Other-Survey
Instrument 2. RF pre and post survey.docx Other-Survey
Instrument 3. Contact information form.docx Other-Contact info
Instrument 4. Implementation log.docx Other-log
Instrument 5. Interview protocol for HMRF staff.docx Other-Interview protocol
STRIVE_Formative ACF Program Support_SSA_CLEAN.docx SSA Prog Support - STRIVE IC Document
STRIVE_Formative ACF Program Support_SSB_clean.docx SSB Prog Support - STRIVE IC Document
Attachment A. Study consent form for HMRF participants.docx Attachment A. Study consent form for HMRF participants IC Document
Attachment B. Study consent form for HMRF staff interviews.docx Attachment B. Study consent form for HMRF staff interviews IC Document
Attachment C. CUES safety card_HMRE programs.docx Attachment C. CUES safety card_HMRE programs IC Document
Attachment D. CUES safety card_RF programs.docx Attachment D. CUES safety card_RF programs IC Document
Attachment E. CUES safety card_AIAN participants CLEAN.docx Attachment E. CUES safety card_AIAN participants IC Document
Attachment F. Information and outreach scripts.docx Attachment F. Information and outreach scripts IC Document

Information Collection (IC) Details

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents:	Number of Respondents for Small Entity:

Affected Public:

Percentage of Respondents Reporting Electronically:

		Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC
Annual IC Time Burden (Hours)
Annual IC Cost Burden (Dollars)

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.