SEED - Clinic Visit -Control Children

The Study to Explore Early Development (SEED)

Documents and Forms

Document Name Document Type
Appendix_G.2 Mullen.pdf Other-WORD
Appendix_P Study Start Dys Exam form.doc Other-WORD
Appendix_P.1 Study Start Child Control Clinic Visit Coversheet 2007.doc Appendix_P IC Document

Information Collection (IC) Details

IC Title:	SEED - Clinic Visit -Control Children	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD			Appendix_G.2 Mullen.pdf		Yes	Yes	Fillable Printable
Other-WORD			Appendix_P Study Start Dys Exam form.doc		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: 214	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	214	-4,394	4,608
Annual IC Time Burden (Hours)	214	-2,090	2,304
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix_P	Appendix_P.1 Study Start Child Control Clinic Visit Coversheet 2007.doc	04/26/2010

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.