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ASD - ENROLLMENT-Invitation Call Script and SCQ (Mother)
The Study to Explore Early Development (SEED) - Phase 3 (Modified for COVID-19 Impact Assessment)
OMB: 0920-1171
IC ID: 224011
OMB.report
HHS/CDC
OMB 0920-1171
ICR 202011-0920-014
IC 224011
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1171 can be found here:
2021-02-18 - No material or nonsubstantive change to a currently approved collection
2020-12-08 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment 5. Social Communication Questionnaire (SCQ).pdf
Other-WORD
Att 21.a. Invitation Call Script - Previous ASD Diagnosis SEED 3_3-7-17.docx
Other-WORD
Attachment 5 CoverSheet_Social Communication Questionnaire (SCQ) pdf.doc
Att 5_Cover Sheet
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
ASD - ENROLLMENT-Invitation Call Script and SCQ (Mother)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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-WORD
Attachment 5. Social Communication Questionnaire (SCQ).pdf
Yes
Yes
Fillable Fileable
Other-WORD
Att 21.a. Invitation Call Script - Previous ASD Diagnosis SEED 3_3-7-17.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0136: Epidemiologic Studies and Surveillance of Disease Problems
FR Citation:
57 FR 62812
Number of Respondents:
859
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
859
0
0
0
0
859
Annual IC Time Burden (Hours)
430
0
0
0
0
430
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att 5_Cover Sheet
Attachment 5 CoverSheet_Social Communication Questionnaire (SCQ) pdf.doc
10/19/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.