OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Clinic Visit - Case Parent

IC 178552 under ICR 200702-0920-001 · OMB 0920-0741.

Documents and Forms
Document Name
Document Type
Other-ADI-R
Other-Early Development Questionnair
Other-Services and Treatments Interv
Other-Vineland Adaptive Behavior Sca
Other-Written Informed Consent Form
Other-Written Informed Consent Docum
Information Collection (IC) Details

View Information Collection (IC)

Clinic Visit - Case Parent
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Written Informed Consent Form Appendix E 3 Informed Consent Case 2007 06.doc Yes Yes Printable Only
Other-Written Informed Consent Document Appendix E.3 Informed Consent NIC&Sub6-4-2007.doc Yes Yes Printable Only
Other-Services and Treatments Interview Appendix F.3 Services and Treatment Q.doc Yes Yes Printable Only
Other-Early Development Questionnaire Appendix F.2 EDQ.doc Yes Yes Printable Only
Other-ADI-R Appendix F.1 ADI-R.pdf Yes Yes Printable Only
Other-Vineland Adaptive Behavior Scales Appendix F.4 Vineland.pdf Yes Yes Printable Only

Health Public Health Monitoring

09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

810 0
   
Individuals or Households
 
   0 %

  Approved 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 4,050 0 4,050 0 0 0
Annual IC Time Burden (Hours) 2,700 0 2,700 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.