Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Consent for Bloodspot Retrieval Modified 1375 344 0 Form and Instruction none Consent for Bloodspot Release
Form and Instruction none Consent for Bloodspot Retrieval - Spanish
Form and Instruction none Consent for Bloodspot Retrieval - Multiples
Form and Instruction none Consent for Bloodspot Retrieval - Multiples - Spanish
Medical Record Request New 385 96 0 Form none Medical Record Release Authorization
Form none Medical Record Release Authorization
Medical Record Review New 385 193 0 Instruction
Mother's Questionnaire Modified 1925 1444 0 Form none BD-STEPS Questionnaire
Form none BD-STEPS Questionnaire - Spanish
Occupational Questionnaires New 642 214 0 Form none Agriculture Questionnaire
Form none Electronic Equipment Operator Questionnaire
Form none Cosmetology Questionnaire
Form none Healthcare Questionnaire
Form none Housekeeping Questionnaire
Form none Office Work Questionnaire
Form none Restaurant Work Questionnaire
Form none Teacher Questionnaire
Total burden requested under this ICR: 4712 2291 0  
To view an IC, click on IC Title