Information Collection

Exploration of Distribution and Reach of Educational Children's Book Amazing Me- It's Busy Being 3! In Pediatric Office Settings

IC 204835 under ICR 201112-0920-014 · OMB 0920-0919.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0919 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Exploration of Distribution and Reach of Educational Children's Book Amazing Me- It's Busy Being 3! In Pediatric Office Settings	Form and Instruction
Amazing Me-It's Busy 3! Book Survey Attach A1_ Amazing Me Task 2 Online Clinic Tracking Survey_FINAL_10-26-12.docx	Form and Instruction
Amazing Me OMB_11-9-12_Final_rev.docx Amazing Me OMB_11-9-12_Final_rev	IC Document
Attach A_Screenshots_ Amazing Me Task 2 Online Tracking Survey Final.docx Attach A_Screenshots_ Amazing Me Task 2 Online Tracking Survey Final	IC Document

IC Title:

Exploration of Distribution and Reach of Educational Children's Book Amazing Me- It's Busy Being 3! In Pediatric Office Settings

Agency IC Tracking Number:

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	Amazing Me-It's Busy 3! Book Survey	Attach A1_ Amazing Me Task 2 Online Clinic Tracking Survey_FINAL_10-26-12.docx		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 575

Number of Respondents for Small Entity: 250

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	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	575	0	0	0	0	0
Annual IC Time Burden (Hours)	32	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Amazing Me OMB_11-9-12_Final_rev	Amazing Me OMB_11-9-12_Final_rev.docx	11/09/2012
Attach A_Screenshots_ Amazing Me Task 2 Online Tracking Survey Final	Attach A_Screenshots_ Amazing Me Task 2 Online Tracking Survey Final.docx	11/09/2012

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