The Community Choice Demonstration

ICR 202403-2528-004

OMB: 2528-0337

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 2528-0337 can be found here:

2025-05-20 - No material or nonsubstantive change to a currently approved collection
2024-10-15 - No material or nonsubstantive change to a currently approved collection

Forms and Documents

Document Name	Status
83c_Community Choice Demonstration_2528-0337_02202024.docx Justification for No Material/Nonsubstantive Change	2024-03-17
83c_Community Choice Demonstration_2528-0337_02202024.docx Justification for No Material/Nonsubstantive Change	2024-03-17
Revised - Attachment P Phase 2 Other Adult Household Member Informed Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-17
Revised - Attachment P Phase 2 Other Adult Household Member Informed Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-17
Revised - Attachment O Phase 2 Head of Household Waitlist Families Informed Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-17
Revised - Attachment O Phase 2 Head of Household Waitlist Families Informed Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-17
Revised - Attachment N Phase 2 HoH Existing Voucher Holders Informed Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-17
Revised - Attachment N Phase 2 HoH Existing Voucher Holders Informed Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-17
Revised - Attachment B Head of Household Existing Voucher Holders Informed Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-17
Revised - Attachment B Head of Household Existing Voucher Holders Informed Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-17
Revised - Attachment D Other Adult Household Member Informed Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-17
Revised - Attachment D Other Adult Household Member Informed Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-17
Revised - Attachment C Head of Household Waitlist Family Informed Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Revised - Attachment C Head of Household Waitlist Family Informed Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment O_The Obesity & Type II Diabetes Risk Assessment_Anthropometric Assessments_Child - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment O_The Obesity & Type II Diabetes Risk Assessment_Anthropometric Assessments_Child - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment N_The Obesity & Type II Diabetes Risk Assessment_Anthropometric Assessments_Adult - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment N_The Obesity & Type II Diabetes Risk Assessment_Anthropometric Assessments_Adult - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment M.2_The Obesity & Type II Diabetes Risk Assessment_Survey_Follow-up - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment M.2_The Obesity & Type II Diabetes Risk Assessment_Survey_Follow-up - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment M.1_The Obesity & Type II Diabetes Risk Assessment_Survey_Baseline - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment M.1_The Obesity & Type II Diabetes Risk Assessment_Survey_Baseline - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment L_The Child and MOVED Assessments_Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment L_The Child and MOVED Assessments_Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment K.2_The Child Assessment-Obesity & Type II Diabetes Risk Assessment_Phone Call Script - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment K.2_The Child Assessment-Obesity & Type II Diabetes Risk Assessment_Phone Call Script - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment D_The Home Assessment_Direct Measurements - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment D_The Home Assessment_Direct Measurements - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment C_The Home Assessment_Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment C_The Home Assessment_Consent - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment B.2_The Home Assessment_Follow-up Phone Call Script - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment B.2_The Home Assessment_Follow-up Phone Call Script - TRACKED CHANGES.docx Supplementary Document	2024-03-15
Attachment J.1_The Child Assessment and The Obesity & Type II Diabetes Risk Assessment _Flyer.pdf Supplementary Document	2023-12-14
Attachment J.1_The Child Assessment and The Obesity & Type II Diabetes Risk Assessment _Flyer.pdf Supplementary Document	2023-12-14
Attachment A.1_The Home Assessment_Flyer.pdf Supplementary Document	2023-12-14
Attachment A.1_The Home Assessment_Flyer.pdf Supplementary Document	2023-12-14
Attachment J.1_The Child Assessment and The Obesity & Type II Diabetes Risk Assessment _Flyer.pdf Supplementary Document	2023-12-14
Attachment J.1_The Child Assessment and The Obesity & Type II Diabetes Risk Assessment _Flyer.pdf Supplementary Document	2023-12-14
30-Day Notice The Community Choice Demonstration.pdf Supplementary Document	2023-10-19
30-Day Notice The Community Choice Demonstration.pdf Supplementary Document	2023-10-19
Attachment A.1_The Home Assessment_Flyer.pdf Supplementary Document	2023-12-14
Attachment A.1_The Home Assessment_Flyer.pdf Supplementary Document	2023-12-14
Evaluation of the Community Choice Demonstration 60-Day Notice.pdf Supplementary Document	2023-10-19
Evaluation of the Community Choice Demonstration 60-Day Notice.pdf Supplementary Document	2023-10-19
Supporting Statement B.docx Supporting Statement B	2023-12-14
Supporting Statement B.docx Supporting Statement B	2023-12-14
Supporting Statement A.docx Supporting Statement A	2023-12-14
Supporting Statement A.docx Supporting Statement A	2023-12-14

IC Document Collections

IC ID	Document Title	Status
266091	PHASE 2- OTHER ADULT HOUSEHOLD MEMBER INFORMED CONSENT FOR STUDY PARTICIPATION Other-Revised - Attachment P Phase 2 Other Adult Household Membe	New
266090	PHASE 2- HEAD OF HOUSEHOLD WAITLIST FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION Other-Revised - Attachment O Phase 2 Head of Household Waitlist	New
266089	PHASE 2- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION Other-Revised - Attachment N Phase 2 HoH Existing Voucher Holder	New
266088	PHASE 1- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION Other-Revised - Attachment B Head of Household Existing Voucher	New
266087	PHA STAFF INTERVIEW GUIDE Other-Revised - Instrument 3 PHA Staff Interview Guide	New
266086	PARENT/GUARDIAN PERMISSION FORM Other-Revised - Attachment E Parent Guardian Permission Form	New
266085	OTHER ADULT HOUSEHOLD MEMBER INFORMED CONSENT FOR STUDY PARTICIPATION Other-Revised - Attachment D Other Adult Household Member Inform	New
266084	Mobility Services Tracking Tool Evaluation of the Housing Choice Voucher Mobility Demonstration Other-Revised - Attachment G Mobility Services Tracking Tool	New
266083	Mobility Services Provider Interview Outreach Evaluation of the Housing Choice Voucher Mobility Demonstration Other-Revised - Attachment K Mobility Services Provider Intervie	New
266082	MOBILITY SERVICES PROVIDERS INTERVIEW GUIDE Other-Revised - Instrument 4 Mobility Services Provider Intervie	New
266081	Landlord Interview Advance Letter Evaluation of the Housing Choice Voucher Mobility Demonstration Other-Revised - Attachment L Landlord Interview Advance Letter	New
266080	INTERVIEW GUIDE FOR PARTICIPATING FAMILIES WHO HAVE LEASED UP Other-Revised - Instrument 6 Interview Guide for Leased Up Famil	New
266079	INTERVIEW GUIDE FOR PARTICIPATING FAMILIES CURRENTLY SEARCHING FOR HOUSING Other-Revised - Instrument 5 Interview Guide for Searching Famil	New
266078	INTERVIEW GUIDE FOR OPPORTUNITY AREA LANDLORDS Other-Revised - Instrument 7 Interview Guide for Participating L	New
266060	Head of Household Family Interview Email Reminder Evaluation of the Housing Choice Voucher Mobility Demonstration Other-Revised - Attachment J Family Interview Email Reminder	New
266059	Head of Household Family Interview Advance Letter Evaluation of the Housing Choice Voucher Mobility Demonstration Other-Revised - Attachment I Family Interview Advance Letter	New
266058	HOUSEHOLD ROSTER AND BASELINE INFORMATION FORM Other-Revised - Instrument 1 Household Roster and Baseline Infor	New
266057	HEAD OF HOUSEHOLD WAITLIST FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION Other-Revised - Attachment C Head of Household Waitlist Family I	New
266056	HEAD OF HOUSEHOLD FAMILY INTERVIEW CONSENT FORM Other-Revised - Attachment H Head of Household Family Interview	New
266055	COST STUDY DATA COLLECTION OUTREACH Other-Revised - Attachment M Cost Interview Advance Letter	New
266054	COST DATA COLLECTION INTERVIEW GUIDE Other-Revised - Instrument 8 Interview Guide for Cost Data Colle	New
266053	BASELINE SURVEY Other-Revised - Instrument 2 HCV Mobility Evaluation Baseline Su	New
262928	Tracking Calls Other-Tracking Calls	Unchanged
262927	Tracking Emails/Texts Other-Tracking Emails/Texts	Unchanged
262926	Semi-Structured Interviews Other-Semi-Structured Interviews	Unchanged
262925	Consent for Semi-Structured Interviews Other-Consent for Semi-Structured Interviews	Unchanged
262924	Blood Pressure Reading (adult) Other-Blood Pressure Reading (adult)	Unchanged
262922	Accelerometers (child) Other-Accelerometers (child)	Unchanged
262921	Accelerometers (adult) Other-Accelerometers (adult)	Unchanged
262919	Home Observations/ Housing Assessment Other-Home Observations/ Housing Assessment	Unchanged
262916	Blood Spot Samples (adult) Other-Blood Spot Samples (adult)	Unchanged
262915	Anthropometric assessments (child, but accounting for parent's time) Other-Anthropometric assessments (child, but accounting for pare	Unchanged
262912	Anthropometric assessments (child) Other-Anthropometric assessments (child)	Modified
262910	Anthropometric assessments (adult) Other-Anthropometric assessments (adult)	Modified
262909	Adult Survey Other-Adult Survey	Modified
262906	Consent for Assessment Other-Consent for Assessment	Modified
262905	Follow-up Call Phone Script Other-Follow-up Call Phone Script	Modified
262904	Email Reminder Other-Email Reminder	Unchanged
262902	Advance Letter Other-Advance Letter	Unchanged
262901	Direct Child Assessment Other-Direct Child Assessment	Unchanged
262900	Survey about child (asked of parent/guardian) and parent/guardian's presence during direct Child Assessment Other-Survey about child (asked of parent/guardian) and parent/g	Unchanged
262899	Consent for Assessment Other-Consent for Assessment	Unchanged
262898	Survey Other-Survey	Unchanged
262897	Interviewer Observations Other-Interviewer Observations	Unchanged
262892	Direct Measurements Other-Direct Measurements	Modified
262891	Consent for Assessment Other-Consent for Assessment	Modified
262890	Follow-up Call Phone Script Other-Follow-up Call Phone Script	Modified
262889	Email Reminder Other-Email Reminder	Unchanged
262887	Advance Letter Other-Advance Letter	Unchanged

ICR Details