Study Consent and Contact Information

Feeding My Baby and Me: Infant Feeding Practices Study III

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1333 can be found here:

Documents and Forms

Document Name Document Type
Study Consent and Contact Information Form and Instruction
Informed Consent and Contact Information Att.5d-Consent Form.docx Form and Instruction
Informed Consent and Contact Information Att.5d-Consent Form.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Study Consent and Contact Information	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
Form and Instruction	n/a	Informed Consent and Contact Information	Att.5d-Consent Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0160, Records of Subjects in Health Promotion and Education Studies	FR Citation: 51 FR 42434

Number of Respondents: 1,570	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,570	1,570
Annual IC Time Burden (Hours)	131	131
Annual IC Cost Burden (Dollars)	3,721	3,721

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.