Document Name Document Type
Form 0920 First Follow-up Core Survey of SEED 1-3 Caregivers Form
Form 0920 First Follow-up Core Survey of SEED 1-3 Caregivers Form
Att 2c - Enrollment Call Script and Consent 1st Survey.docx Other-Script
Att 2c - Enrollment Call Script and Consent 1st Survey.docx Other-Script
0920 SEED Follow-Up Health and Development Core Survey Att 2f-h - First Follow-up Core Survey of SEED 1-3 Caregivers.pdf Form
0920 SEED Follow-Up Health and Development Core Survey Att 2f-h - First Follow-up Core Survey of SEED 1-3 Caregivers.pdf Form
SEED Follow-Up Health and Development Core Survey - Span Att 2f_S - First Follow-up Core Survey of SEED 1-3 Caregivers_Spanish_final.docx Form and Instruction
SEED Follow-Up Health and Development Core Survey - Span Att 2f_S - First Follow-up Core Survey of SEED 1-3 Caregivers_Spanish_final.docx Form and Instruction
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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	First Follow-up Core Survey of SEED 1-3 Caregivers	Agency IC Tracking Number:	0920-21IK

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	0920	SEED Follow-Up Health and Development Core Survey	Att 2f-h - First Follow-up Core Survey of SEED 1-3 Caregivers.pdf	No	Fillable Fileable
Other-Script			Att 2c - Enrollment Call Script and Consent 1st Survey.docx	No	Paper Only
Form and Instruction	n/a	SEED Follow-Up Health and Development Core Survey - Spanish	Att 2f_S - First Follow-up Core Survey of SEED 1-3 Caregivers_Spanish_final.docx	No	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,234	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	1,234	1,234
Annual IC Time Burden (Hours)	823	823
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.

First Follow-up Core Survey of SEED 1-3 Caregivers

[NCBDDD] The Study to Explore Early Development (SEED) Follow-up Study

OMB: 0920-1392

IC ID: 255807

View Information Collection (IC)