Information Collection

GenIC Testing Act Early Messages for "Learn the Signs. Act Early

IC 210966 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⚠️ Notice: This information collection may be referencing outdated material.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
Att_A AE Message Testing Parent Focus Group Screener.docx	Other-WORD
Att_B AE Message Testing Parent Focus Group Informed Consent.docx	Other-WORD
Att_C AE Message Testing parent focus group guide.docx	Other-WORD
Att_D LTSAE Milestone Moments Booklet.pdf Att_D LTSAE Milestone Moments Booklet	IC Document
Att_E AE LTSAE Track Developmental Milestones Brochure.pdf Att_E AE LTSAE Track Developmental Milestones Brochure	IC Document
Att_G AE Message Testing Clinic recruitment factsheet.docx Att_G AE Message Testing Clinic recruitment factsheet	IC Document
Att_F AE Message Testing LTSAE Checklist.pdf Att_F AE Message Testing LTSAE Checklist	IC Document
Att_H AE Message Testing Parent FG recruitment poster.docx Att_H AE Message Testing Parent FG recruitment poster	IC Document
Att_I AE Message Testing Parent FG recruitment handout.docx Att_I AE Message Testing Parent FG recruitment handout	IC Document
AE Message Testing T1 GenIC Clearance Submission.docx Justification	IC Document

IC Title:

GenIC Testing Act Early Messages for "Learn the Signs. Act Early

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD	Att_A AE Message Testing Parent Focus Group Screener.docx	No	No	Fillable Printable
Other-WORD	Att_B AE Message Testing Parent Focus Group Informed Consent.docx	No	No	Fillable Printable
Other-WORD	Att_C AE Message Testing parent focus group guide.docx	No	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 280

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 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	280	0	0	0	0	0
Annual IC Time Burden (Hours)	100	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
Att_D LTSAE Milestone Moments Booklet	Att_D LTSAE Milestone Moments Booklet.pdf	03/27/2014
Att_E AE LTSAE Track Developmental Milestones Brochure	Att_E AE LTSAE Track Developmental Milestones Brochure.pdf	03/27/2014
Att_G AE Message Testing Clinic recruitment factsheet	Att_G AE Message Testing Clinic recruitment factsheet.docx	03/27/2014
Att_F AE Message Testing LTSAE Checklist	Att_F AE Message Testing LTSAE Checklist.pdf	03/27/2014
Att_H AE Message Testing Parent FG recruitment poster	Att_H AE Message Testing Parent FG recruitment poster.docx	03/27/2014
Att_I AE Message Testing Parent FG recruitment handout	Att_I AE Message Testing Parent FG recruitment handout.docx	03/27/2014
Justification	AE Message Testing T1 GenIC Clearance Submission.docx	03/27/2014

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