Information Collection

SEED - Clinic Visit- Case Child

IC 178555 under ICR 201005-0920-003 · OMB 0920-0741.

Documents and Forms

Document Name Document Type
Appendix_G.1 ADOS.pdf Other-WORD
Appendix_G.2 Mullen.pdf Other-WORD
Appendix_P Study Start Dys Exam form.doc Other-WORD
Appendix P.1_ Dysmorphology Protocol.doc Appendix P IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SEED - Clinic Visit- Case Child	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD	Appendix_G.1 ADOS.pdf	Yes	Yes	Fillable Printable
Other-WORD	Appendix_G.2 Mullen.pdf	Yes	Yes	Fillable Printable
Other-WORD	Appendix_P Study Start Dys Exam form.doc	Yes	Yes	Fillable Printable

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: 107	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	107	-2,323	2,430
Annual IC Time Burden (Hours)	161	-1,190	1,351
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix P	Appendix P.1_ Dysmorphology Protocol.doc	04/27/2010

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