AAP 3 Month Follow-up Survey (Pediatrics)

Improving Fetal Alcohol Spectrum Disorders Prevention and Practice through Practice and Implementation Centers and National Partnerships

OMB: 0920-1129

IC ID: 220411

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

AAP 3 Month Follow-up Survey (Pediatrics) 0920-1129 (17AUR)
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1129 AAP Three-month Follow-up Evaluation Survey AAP Three-month Follow-up Evaluation Survey-Spanish Version_Screenshot_R....pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

120 0
   
Individuals or Households
 
   100 %

  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 0 0 0 -120 120 0
Annual IC Time Burden (Hours) 0 0 0 -4 4 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
AAP Three-month Follow-up Evaluation Suvey AAP Six Month Follow Up Evaluation Survey_Final_Spanish_REVIEWED.docx 07/20/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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