12-Month Interview (PB, EH, TT-HI, PBS)

Provider-Based Sampling Feasibility Study for the Vanguard (Pilot) Study and Data Collection Updates for the National Children's Study (NICHD)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 22.1 12-Month Interview (PB, EH, TT-HI, PBS) Form and Instruction
22.1 Survey 12-Month Mother Interview 20120413.docx Form and Instruction
22.2 Survey 12-Month Mother SAQ.docx Form and Instruction
22.3 Survey - Placeholder for Copyrighted Material Brief Infant Toddler Social Emotional Assessment (BITSEA) SAQ.docx Form and Instruction

Information Collection (IC) Details

IC Title:	12-Month Interview (PB, EH, TT-HI, PBS)	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	22.1	Survey	12-Month Mother Interview 20120413.docx	Yes	Yes	Paper Only
Form and Instruction	22.2	Survey	12-Month Mother SAQ.docx	Yes	Yes	Paper Only
Form and Instruction	22.3	Survey - Placeholder for Copyrighted Material	Brief Infant Toddler Social Emotional Assessment (BITSEA) SAQ.docx	Yes	Yes	Paper Only

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: 1,003	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	1,003	-1,363	2,366
Annual IC Time Burden (Hours)	836	-347	1,183
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.