54-Month Interview

Continuation of National Children's Study Vanguard (Pilot) Study Data Collection: Study Visits through 60-Months and Sibling Birth Enrollment

OMB: 0925-0593

IC ID: 210028

Information Collection (IC) Details

View Information Collection (IC)

54-Month Interview
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 36.1 Survey 54MQuestionnaireChild.docx Yes Yes Paper Only
Form and Instruction 36.2 Survey 54MQuestionnaireAdult.docx Yes Yes Paper Only
Form and Instruction 36.3 Survey DietaryFoodFrequencySAQ.docx Yes Yes Paper Only

General Science and Innovation Scientific and Technological Research and Innovation

 

1,431 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 1,431 0 1,431 0 0 0
Annual IC Time Burden (Hours) 804 0 804 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
HIPAAHealthUseDisclosureAuthorizationForm HIPAAHealthUseDisclosureAuthorizationForm.docx 01/15/2014
InformedConsentFormAdult InformedConsentFormAdult.docx 01/15/2014
MultiModeVisitInformationScript MultiModeVisitInformationScript.docx 01/15/2014
ParentalPermissionChildParticipation6MonthtoAgeMajority ParentalPermissionChildParticipation6MonthtoAgeMajority.docx 01/15/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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