SEED - Clinic Visit- Case Parent

The Study to Explore Early Development (SEED)

Documents and Forms

Document Name Document Type
Appendix_F.1 ADI_R.pdf Other-WORD
Appendix_F.3 Study Start Services and Treatment Questionnaire 2007.doc Other-WORD
Appendix_F.2 Study Start EDQ 2007.doc Other-WORD
Appendix_F.4 Vineland.pdf Other-WORD

Information Collection (IC) Details

IC Title:	SEED - Clinic Visit- Case Parent	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD	Appendix_F.1 ADI_R.pdf	Yes	Yes	Fillable Printable
Other-WORD	Appendix_F.3 Study Start Services and Treatment Questionnaire 2007.doc	Yes	Yes	Fillable Printable
Other-WORD	Appendix_F.2 Study Start EDQ 2007.doc	Yes	Yes	Fillable Printable
Other-WORD	Appendix_F.4 Vineland.pdf	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 107	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	107	-3,943	4,050
Annual IC Time Burden (Hours)	375	-2,325	2,700
Annual IC Cost Burden (Dollars)	0	0	0

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.