Information Collection

Parent Survey 2 - Parents using the Milestone Tracker App who complete 65% or more of a checklist using the app AND indicate a missed milestone or identify a developmental concern

IC 258176 under ICR 202605-0920-002 · OMB 0920-1397.

Documents and Forms

Document Name Document Type
Form 0920-1397 Parent Survey 2 Parent Survey 2 - Parents using the Milestone Tracker App who complete 65% or more of a checklist using the app AND indicate a missed milestone or identify a developmental concern Form and Instruction
Form 0920-1397 Parent Survey 2 - Spanish Parent Survey 2 - Parents using the Milestone Tracker App who complete 65% or more of a checklist using the app AND indicate a missed milestone or identify a developmental concern Form and Instruction
0920-1397 Parent Survey 2 F_Parent 2.docx Form and Instruction
0920-1397 Parent Survey 2 - Spanish MT Parent Survey 2 Spanish FINAL .docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Parent Survey 2 - Parents using the Milestone Tracker App who complete 65% or more of a checklist using the app AND indicate a missed milestone or identify a developmental concern	Agency IC Tracking Number:

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1397	Parent Survey 2	F_Parent 2.docx	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1397	Parent Survey 2 - Spanish	MT Parent Survey 2 Spanish FINAL .docx	N/A	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	5,000	-195,000	200,000
Annual IC Time Burden (Hours)	420	-16,247	16,667
Annual IC Cost Burden (Dollars)	0	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.

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