PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Male Partners - Adult Symptoms Questionnaire
New
4375
729
0
Form and Instruction
NA
ZEN Columbia - Adult Symptoms Questionnaire - Spanish
Form and Instruction
NA
ZEN Columbia - Adult Symptoms Questionnaire - English
Male Partners - Male Enrollment Questionnaire
New
625
260
0
Form and Instruction
NA
ZEN Columbia - Male Partner Enrollment Questionnaire - Spanish
Form and Instruction
NA
ZEN Columbia - Male Partner Enrollment Questionnaire - English 26MAY2017
Male Partners - Male Partner Eligibility Questionnaire
New
2500
208
0
Form and Instruction
NA
ZEN Columbia - Male Partner Eligibility - Spanish
Form and Instruction
NA
ZEN Columbia - Male Partner Eligibility - English 26MAY2017
Pregnant Women - Adult Symptoms Questionnaire
New
37500
6250
0
Form and Instruction
NA
ZEN Columbia - Adult Symptoms Questionnaire - Spanish
Form and Instruction
NA
ZEN Columbia - Adult Symptoms Questionnaire - English
Pregnant Women - Ages and Stages 2 Month Questionnaire
New
2250
563
0
Form and Instruction
NA
Ages and Stages Questionnaire - 2 month English
Form and Instruction
NA
Ages and Stages Questionnaire - 2 month Spanish
Pregnant Women - Ages and Stages 6 Month Questionnaire
New
2250
563
0
Form and Instruction
NA
Ages and Stages Questionnaire - 6 month English
Form and Instruction
NA
Ages and Stages Questionnaire - 6 month Spanish
Pregnant Women - Infant Symptoms Questionnaire
New
31500
5250
0
Form and Instruction
NA
ZEN Columbia - Infant Symptoms Questionnaire - Spanish
Pregnant Women - Pregnant Women Eligibility Questionnaire
New
3125
260
0
Form and Instruction
NA
ZEN Columbia: Pregnant Woman Eligibility - Spanish
Form and Instruction
NA
ZEN Colombia: Pregnant Woman Eligibility - English 26MAY2017
Pregnant Women - Pregnant Women Enrollment Questionnaire
New
2500
1458
0
Form and Instruction
NA
ZEN Columbia - Pregnant Woman Enrollment Questionnaire - Spanish
Form and Instruction
NA
ZEN Columbia - Pregnant Woman Enrollment Questionnaire - English 26MAY2017
Pregnant Women - Pregnant Women Follow-Up Questionnaire
New
20000
5000
0
Form and Instruction
NA
ZEN Columbia - Pregnant Woman Follow-Up Questionnaire - Spanish
Form and Instruction
NA
ZEN Columbia - Pregnant Woman Follow-Up Questionnaire - English 26MAY2017
Total burden requested under this ICR:
106625
20541
0
To view an IC, click on IC Title
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