Clinic / Home Vist -- Saliva Collection (Father)

The Study to Explore Early Development (SEED) - Phase 3 (Modified for COVID-19 Impact Assessment)

Documents and Forms

Document Name Document Type
Attachment 16.b. Saliva Collection Instructions Form SEED 3.docx Instruction
Attachment 16.b. Saliva Collection Instructions Form SEED 3.docx Instruction
Attachment 16.c. Saliva Consent Form SEED 3.docx Other-WORD
Attachment 16.c. Saliva Consent Form SEED 3.docx Other-WORD
Attachment 16.d. Saliva Transmittal Form SEED 3_tmj8-25-17.doc Other-WORD
Attachment 16.d. Saliva Transmittal Form SEED 3_tmj8-25-17.doc Other-WORD

Information Collection (IC) Details

IC Title:	Clinic / Home Vist -- Saliva Collection (Father)	Agency IC Tracking Number:	16PA

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Instruction	Attachment 16.b. Saliva Collection Instructions Form SEED 3.docx	No	Paper Only
Other-WORD	Attachment 16.c. Saliva Consent Form SEED 3.docx	No	Fillable Fileable Signable
Other-WORD	Attachment 16.d. Saliva Transmittal Form SEED 3_tmj8-25-17.doc	No	Fillable Fileable

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: 164	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	164	164
Annual IC Time Burden (Hours)	41	41
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.