DASH Biospecimen 2019 Individuals (NICHD)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NICHD)

Documents and Forms

Document Name Document Type
Form 1 DASH Biospecimen 2019 Individuals (NICHD) Form
1 DASH Biospecimen screenshots 0925-0643_substudy_NICHD DASH Biospecimen_Survey Screenshots.docx Form
0925-0643_substudy_NICHD DASH Biospecimen_2019_Individuals.docx DASH Biospecimen 2019 Individuals substudy IC Document

Information Collection (IC) Details

IC Title:	DASH Biospecimen 2019 Individuals (NICHD)	Agency IC Tracking Number:

IC Status: New

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
Form	1	DASH Biospecimen screenshots	0925-0643_substudy_NICHD DASH Biospecimen_Survey Screenshots.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	16	16
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
DASH Biospecimen 2019 Individuals substudy	0925-0643_substudy_NICHD DASH Biospecimen_2019_Individuals.docx	08/12/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.