Information Collection

Postnatal Activities - Mother and Children

IC 184279 under ICR 200803-0925-005 · OMB 0925-0593.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0593 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Postnatal Activities - Mother and Children	Form and Instruction
1 Survey A.1.4.b 6 Month Mother Interview_Revised.doc	Form and Instruction
1 Survey A.1.4.a 3 Month Phone Call.doc	Form and Instruction
1 Survey A.1.4.c 9 Month Phone Call.doc	Form and Instruction
1 Survey A.1.4.d 12 Month Mother Interview_Revised.doc	Form and Instruction
1 Survey A.1.4.e 18 month phone interview topics only.doc	Form and Instruction
1 Survey A.1.4.f 24 Month Phone Interview Subject Areas.doc	Form and Instruction
1 Survey A.2.1.b 4-M1 (Lactation) FFQ.doc	Form and Instruction
1 Survey A.2.1.d Family Medical History.doc	Form and Instruction
1 Survey A.2.1.h Participant Evaluation Questionnaire_Revised.doc	Form and Instruction
1 Survey A.2.1.i 6 month SAQ.doc	Form and Instruction
1 Survey A.2.1.j 12 month SAQ.doc	Form and Instruction
1 Survey A.2.1.k Infant Feeding Form.doc	Form and Instruction
1 Survey A.2.1.k 2-Infant Feeding Form 6 months.doc	Form and Instruction
1 Survey A.2.3.l.6 Blood Draw Data Collection Form_Revised.doc	Form and Instruction
1 Survey A.2.1.m Child Food Frequency Questionnaire.doc	Form and Instruction
1 Survey A.2.1.n Infant 3-Day Checklist.doc	Form and Instruction
1 Survey A.2.1.n Infant 3-Day Checklist.doc	Form and Instruction
1 Survey A.2.1.o Infant Child 3-Day Time and Place Diaries.doc	Form and Instruction
1 Survey A.2.1.o 1-6 Mo Time and Place Diary.doc	Form and Instruction
1 Survey A.2.1.p Infant Medical Care Log.doc	Form and Instruction
1 Survey A.2.3.p 2-24 month Vacuum Dust Self Collection Form.doc	Form and Instruction
1 Survey A.2.3.d 6 Month Pre-Visit Instructions.doc	Form and Instruction
1 Survey A.2.3.e 12 month Pre-Visit Instructions.doc	Form and Instruction
1 Survey A.2.3.j 4-Child Saliva Collection Instructions.doc	Form and Instruction
1 Survey A.2.3.j 5-Child Saliva Data Collection Form Day 1.doc	Form and Instruction
1 Survey A.2.3.j 6-Child Saliva Data Collection Form Day 2.doc	Form and Instruction
1 Survey A.2.3.k Breast Milk Data Collection Form.doc	Form and Instruction
1 Survey A.2.3.k 2-Breast Milk Data Collection Form.doc	Form and Instruction
1 Survey A.2.3.l 6-Blood Draw Data Collection Form 12 months Child.doc	Form and Instruction
1 Survey A.2.3.m.2 Child Hair Data Collection Form.doc	Form and Instruction
1 Survey A.2.3.o 1-Dust Plate Self Collect Instructions.doc	Form and Instruction
1 Survey A.2.3.o 2-Dust Plate Self Collect Form.doc	Form and Instruction
1 Survey A.2.3.q 2-T3_24 Month One Air badge questionnaire.doc	Form and Instruction
1 Survey A.2.3.p 24 month Vacuum Dust Self Collection Form.doc	Form and Instruction
1 Survey A.2.3.p 2-24 month Vacuum Dust Self Collection Form.doc	Form and Instruction
1 Survey A.2.3.q 1-T3_24 month One Air badge collection instructions.doc	Form and Instruction
1 Survey A.2.3.q Air Badge Questionnaire.doc	Form and Instruction
1 Survey A.2.3.q 3-T3_24 month Two Air badges collection instructions.doc	Form and Instruction
1 Survey A.2.3.r 24 month Pesticide Wipe Form.doc	Form and Instruction
1 Survey A.2.3.r 2-24 month Pesticide Wipe Form.doc	Form and Instruction
1 Survey A.2.3.s Environmental Questions_Revised.doc	Form and Instruction
1 Survey A.3.1 KBIT-2.doc	Form and Instruction
1 Survery A.2.3.j.7 Child Saliva Collection Form_Revised.doc	Form and Instruction
1 Survey A.2.3.t_Environmental_Brochure_Air.doc	Form and Instruction
1 Survey A.2.3.u Environmental Letter -- Water.doc	Form and Instruction
1 Survey A.3.5 Three Bags Task.doc	Form and Instruction
1 Survey A.3.6 Bayley Scales of Infant and Toddler Development.doc	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Postnatal Activities - Mother and Children

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Survey	A.1.4.a 3 Month Phone Call.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.1.4.e 18 month phone interview topics only.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.1.4.f 24 Month Phone Interview Subject Areas.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.b 4-M1 (Lactation) FFQ.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.k 2-Infant Feeding Form 6 months.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.n Infant 3-Day Checklist.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.o 1-6 Mo Time and Place Diary.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.o 2-Dust Plate Self Collect Form.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.q 2-T3_24 Month One Air badge questionnaire.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.p 2-24 month Vacuum Dust Self Collection Form.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.q 1-T3_24 month One Air badge collection instructions.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.q 3-T3_24 month Two Air badges collection instructions.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.r 2-24 month Pesticide Wipe Form.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.3.1 KBIT-2.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.o 1-Dust Plate Self Collect Instructions.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.p 2-24 month Vacuum Dust Self Collection Form.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.d 6 Month Pre-Visit Instructions.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.e 12 month Pre-Visit Instructions.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.j 4-Child Saliva Collection Instructions.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.j 5-Child Saliva Data Collection Form Day 1.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.j 6-Child Saliva Data Collection Form Day 2.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.k 2-Breast Milk Data Collection Form.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.l 6-Blood Draw Data Collection Form 12 months Child.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.3.5 Three Bags Task.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.n Infant 3-Day Checklist.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.3.6 Bayley Scales of Infant and Toddler Development.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.m Child Food Frequency Questionnaire.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.1.4.d 12 Month Mother Interview_Revised.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.1.4.c 9 Month Phone Call.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.t_Environmental_Brochure_Air.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.u Environmental Letter -- Water.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.m.2 Child Hair Data Collection Form.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survery	A.2.3.j.7 Child Saliva Collection Form_Revised.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.s Environmental Questions_Revised.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.p Infant Medical Care Log.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.j 12 month SAQ.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.k Infant Feeding Form.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.l.6 Blood Draw Data Collection Form_Revised.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.h Participant Evaluation Questionnaire_Revised.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.k Breast Milk Data Collection Form.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.r 24 month Pesticide Wipe Form.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.i 6 month SAQ.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.o Infant Child 3-Day Time and Place Diaries.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.p 24 month Vacuum Dust Self Collection Form.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.1.4.b 6 Month Mother Interview_Revised.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.3.q Air Badge Questionnaire.doc	Yes	Yes	Paper Only
Form and Instruction	1	Survey	A.2.1.d Family Medical History.doc	Yes	Yes	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 893

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,572	3,572
Annual IC Time Burden (Hours)	2,893	2,893
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.