Parent-Child Enrollment Questionnaire

ZEN Colombia Study: Zika in Pregnant Women and Children in Colombia

OMB: 0920-1190

IC ID: 229192

Information Collection (IC) Details

View Information Collection (IC)

Parent-Child Enrollment Questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction none Parent Child Enrollment Questionnaire Att B9_Parent_Child_Enrollment_Questionnaire_08FEB2018_clean.docx No   Paper Only
Form and Instruction none Parent Child Enrollment Questionnaire - Spanish Att C9_Cuestionario_inscripcion_padre_bebe_08FEB2018_clean.docx No   Paper Only

Health Public Health Monitoring

09-20-0113 - Epidemic Investigation Case Records System  51 FR 42466

900 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 900 0 0 0 0 900
Annual IC Time Burden (Hours) 225 0 -75 0 0 300
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Parent Child Enrollment Questionnaire - trkchg Att B9_Parent_Child_Enrollment_Questionnaire_08FEB2018_track.docx 03/26/2018
Parent Child Enrollment Questionnaire - Spanish - trkchg Att C9_Cuestionario_inscripcion_padre_bebe_08FEB2018_track.docx 03/26/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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