SEARCH Health Questionnaire (Parent_Feb 2014) Cohort Study

SEARCH for Diabetes in Youth Study

Documents and Forms

Document Name Document Type
4b.2_Health Questionnaire (Parent_ Feb 2014).pdf Other-PDF

Information Collection (IC) Details

IC Title:	SEARCH Health Questionnaire (Parent_Feb 2014) Cohort Study	Agency IC Tracking Number:	0920-0904

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-PDF			4b.2_Health Questionnaire (Parent_ Feb 2014).pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: 09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 710	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-710	710
Annual IC Time Burden (Hours)	-178	178
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.