30-Month Interview (PB, EH, TT-HI, TT-LI, 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⚠️ Notice: This information collection may be referencing outdated material.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 26.1 30-Month Interview (PB, EH, TT-HI, TT-LI, PBS) Form and Instruction
26.1 Survey 30 MO Interview 20120413.docx Form and Instruction
26.3 Survey - Placeholder for copyrighted material Brief Symptom Index SAQ.docx Form and Instruction
26.4 Survey - Placeholder for copyrighted material Infant & Toddler Sensory Profile SAQ.docx Form and Instruction
26.2 Survey Brief Infant Toddler Social Emotional Assessment (BITSEA) SAQ.docx Form and Instruction

Information Collection (IC) Details

IC Title:	30-Month Interview (PB, EH, TT-HI, TT-LI, PBS)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	26.1	Survey	30 MO Interview 20120413.docx	Yes	Yes	Paper Only
Form and Instruction	26.3	Survey - Placeholder for copyrighted material	Brief Symptom Index SAQ.docx	Yes	Yes	Fillable Printable
Form and Instruction	26.4	Survey - Placeholder for copyrighted material	Infant & Toddler Sensory Profile SAQ.docx	Yes	Yes	Fillable Printable
Form and Instruction	26.2	Survey	Brief Infant Toddler Social Emotional Assessment (BITSEA) SAQ.docx	Yes	Yes	Fillable Printable

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: 1,188	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
Annual Number of Responses for this IC	1,188	1,188
Annual IC Time Burden (Hours)	1,089	1,089
Annual IC Cost Burden (Dollars)	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.