OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Formative - Developmental

IC 193580 under ICR 201211-0925-001 · OMB 0925-0593.

Documents and Forms
Document Name
Document Type
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Other-Research
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

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Formative - Developmental
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Research Note to File - Formative Research (updated 20130204).docx Yes Yes Paper Only
Form and Instruction none Attach B25. Participant Verification Birth Cohort Attach B25. Participant Verification Birth Cohort.docx Yes Yes Paper Only
Instruction Burden 19 HiLo Household Inventory Questionnaire 20110420 - LOIx-QUEX-01-B-1.DOCX Yes Yes Paper Only
Instruction Burden 20 Participant Internet Usage and Contact Preference Survey 20110420 - LOI2-INF-17.docx Yes Yes Paper Only
Instruction Burden 125 Exemplar Demographics 20110621 - LOI3-PHYS-02.docx Yes Yes Paper Only
Instruction Burden 250 Measurement Form 20110621 - LOI3-PHYS-02.pdf Yes Yes Paper Only
Instruction Burden 38 Contact Info 20110621 - LOI3-PHYS-01.docx Yes Yes Paper Only
Instruction Burden 38 Exit Survey 20110621 - LOI3-PHYS-01.docx Yes Yes Paper Only
Instruction Burden 38 Visit Screen 20110621 - LOI3-PHYS-01.docx Yes Yes Paper Only
Instruction Burden 75 Questionnaire 20110621 - LOI3-PHYS-01.docx Yes Yes Paper Only
Instruction Burden 15 Acculturation Instrument 20110621 - LOI2-QUEX-14.docx Yes Yes Paper Only
Instruction Burden 37 Second Acceptability Questionnaire 20110621 - LOI2-QUEX-14.doc Yes Yes Paper Only
Instruction Burden 38 Initial Acceptability Questionnaire 20110621 - LOI2-QUEX-14.doc Yes Yes Paper Only
Instruction Burden 90 Food Record 20110621 - LOI2-QUEX-14.docx Yes Yes Paper Only
Instruction Burden 100 NCS FFQ 20110621 - LOI2-QUEX-14.pdf Yes Yes Paper Only
Instruction Burden 38 Screening 20110621 - LOI3-PHYS-01.docx Yes Yes Paper Only
Instruction Burden 250 NCS ASA24 Protocol (Placeholder for web survey) 20110621 - LOI2-QUEX-14.docx Yes Yes Paper Only
Instruction Burden 900 B.1.2 LOI3-BIO-02 Exemplar Screening Interview.docx Yes Yes Paper Only
Instruction Burden 900 B.1.7 LOI3-BIO-02 Exemplar Interview.docx Yes Yes Paper Only
Instruction Burden 225 B.2.4 LOI2-PHYS-15 Exemplar Participant Experience Survey.docx Yes Yes Paper Only
Form and Instruction 17.1 Survey Attach B3. LOI2-QUEX-14 SocioDemographics.docx Yes Yes Paper Only
Instruction Attach B5. LOI2-QUEX-14 ASA24 Protocol.docx Yes Yes Paper Only
Instruction Attach B6. LOI2-QUEX-14 Food Diary Instructions-Parent.doc Yes Yes Paper Only
Form and Instruction 17.2 Survey Attach B7. LOI2-QUEX-14 Infant Acceptability Questionnaire #1.doc Yes Yes Fillable Printable
Form and Instruction 17.3 Survey Attach B8. LOI2-QUEX-14 Infant Acceptability Questionnaire #2.doc Yes Yes Fillable Printable
Form and Instruction 17.4 Survey Attach B9. LOI2-QUEX-14 Child Acceptability Questionnaire #1.doc Yes Yes Fillable Printable
Form and Instruction 17.5 Survey Attach B10. LOI2-QUEX-14 Child Acceptability Questionnaire #2.doc Yes Yes Fillable Printable
Form and Instruction 17.6 Survey Attach B11. LOI2-QUEX-14 Infant Feeding Questionniare.pdf Yes Yes Paper Only
Form and Instruction 17.8 Survey Attach B16. LOI2-QUEX-14 Recruitment Screener.pdf Yes Yes Paper Only
Form and Instruction 17.9 Survey Attach B21. Biospecimen Infant Blood Spot Instrument.docx Yes Yes Paper Only
Form and Instruction 17.10 Survey Attach B22. Biospecimen Cord Blood Instrument.docx Yes Yes Paper Only
Form and Instruction 17.11 Survey Attach B23. Biospecimen Placenta and Umbilical Cord Data Collection.docx Yes Yes Paper Only
Form and Instruction 17.7 Survey Attach B12. LOI2-QUEX-14 Child Food Questionnaire.pdf Yes Yes Fillable Printable
Instruction Attach B4. LOI2-QUEX-14 ASA24 Instructions.pdf Yes Yes Paper Only

General Science and Innovation Scientific and Technological Research and Innovation

 

4,847 0
   
Individuals or Households
 
   0 %

  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 4,847 0 0 0 0 4,847
Annual IC Time Burden (Hours) 4,847 0 0 0 0 4,847
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attach B2. LOI2-QUEX-14 Exemplar Consent Form Attach B2. LOI2-QUEX-14 Exemplar Consent Form.doc 10/19/2012
Attach B13. LOI2-QUEX-14 IRB Approval Letters Attach B13. LOI2-QUEX-14 IRB Approval Letters.pdf 10/19/2012
Attach B15. LOI2-QUEX-14 Exemplar Recruitment Flyer Attach B15. LOI2-QUEX-14 Exemplar Recruitment Flyer.docx 10/19/2012
Attach B17. Vanguard (Pilot) Study Biospecimen Collection Chart Attach B17. Vanguard Pilot Study Biospecimen Collection Chart.docx 10/19/2012
Attach B14. LOI2-QUEX-14 Manual of Procedures Attach B14. LOI2-QUEX-14 Manual of Procedures.pdf 10/19/2012
Attach B1. LOI2-QUEX-14-Phase 2 OIRA Template Attach B1. LOI2-QUEX-14-Phase 2 OIRA Template.docx 11/01/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.