Information Collection

SEED Follow-up – Call Script for SEED 1-3 Caregivers (1st Follow-Up)

IC 256059 under ICR 202208-0920-007 · OMB 0920-1392.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1392 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 2c - Enrollment Call Script and Consent 1st Survey.docx	Other-Script
Att 2c - Enrollment Call Script and Consent 1st Survey.docx	Other-Script
Att 2a - Invitation Letter 1st Survey.docx Invitation Letter 1st Survey	IC Document
Att 2a - Invitation Letter 1st Survey.docx Invitation Letter 1st Survey	IC Document
Att 2b - Response Card 1st Survey.docx Response Card 1st Survey	IC Document
Att 2b - Response Card 1st Survey.docx Response Card 1st Survey	IC Document
Att 2d - Participant Information Sheet for SEED 1-3 Caregivers_3-28-22.docx Participant Information Sheet	IC Document
Att 2d - Participant Information Sheet for SEED 1-3 Caregivers_3-28-22.docx Participant Information Sheet	IC Document
Att 2e - Consent Form for Genetic Data Sharing.docx Consent for Genetic Data Sharing	IC Document
Att 2e - Consent Form for Genetic Data Sharing.docx Consent for Genetic Data Sharing	IC Document

IC Title:

SEED Follow-up â Call Script for SEED 1-3 Caregivers (1st Follow-Up)

Agency IC Tracking Number:

0920-21IK

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Script			Att 2c - Enrollment Call Script and Consent 1st Survey.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,057

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	2,057	823	1,234
Annual IC Time Burden (Hours)	343	-480	823
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Invitation Letter 1st Survey	Att 2a - Invitation Letter 1st Survey.docx	09/12/2022
Response Card 1st Survey	Att 2b - Response Card 1st Survey.docx	09/12/2022
Participant Information Sheet	Att 2d - Participant Information Sheet for SEED 1-3 Caregivers_3-28-22.docx	09/12/2022
Consent for Genetic Data Sharing	Att 2e - Consent Form for Genetic Data Sharing.docx	09/12/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.