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
Bayley Scales of Infant and Toddler Development
New
2700
1350
0
Form
NA
Standardized Infant Assessments
Center for Epidemiologic Studies Depression Scale
New
4500
375
0
Form
NA
Center for Epidemiologic Studiesd Depression Scale
Male Partners - Adult Symptoms Questionnaire
Modified
875
146
0
Form and Instruction
NA
ZEN Columbia - Adult Symptoms Questionnaire - English
Form
none
ZEN Colombia: Adult Symptoms - Spanish
Male Partners - Male Enrollment Questionnaire
Modified
125
52
0
Form and Instruction
NA
ZEN Columbia - Male Partner Enrollment Questionnaire - English 26MAY2017
Form and Instruction
NA
ZEN Columbia: Male Partner Enrollment Questionnaire - Spanish 08SEP2017
Male Partners - Male Partner Eligibility Questionnaire
Modified
150
13
0
Form and Instruction
NA
ZEN Columbia - Male Partner Eligibility - English 26MAY2017
Form
none
ZEN Colombia : Male Partner Eligibility - Spanish
Parent-Child Eligibility Questionnaire
New
1000
83
0
Form and Instruction
NA
Parent-Child Follow-Up Eligibility Screening Form - English
Form and Instruction
NA
Parent-Child Follow-Up Eligibility Screening Form - Spanish
Parent-Child Enrollment Questionnaire
New
900
300
0
Form and Instruction
NA
Parent-Child Follow-Up Enrollment Form - English
Form and Instruction
NA
Parent-Child Follow-Up Enrollment Form - Spanish
Parent-Child Follow-Up Questionnaire
New
3600
900
0
Form and Instruction
NA
Parent-Child Follow-Up Questionnaire - English
Form and Instruction
NA
Parent-Child Follow-Up Questionnaire - Spanish
Parenting Stress Index IV
New
4500
750
0
Form
NA
Standardized Infant Assessments
Peabody Developmental Motor Scales
New
900
450
0
Form
NA
Standardized Infant Assessments
Pregnant Women - Adult Symptoms Questionnaire
Modified
7500
1250
0
Form and Instruction
NA
ZEN Columbia - Adult Symptoms Questionnaire - English
Form
none
ZEN Colombia: Adult Symptoms - Spanish
Pregnant Women - Ages and Stages 2 and 24 Month Questionnaire
Modified
4500
1125
0
Form and Instruction
NA
Ages and Stages Questionnaire - 2 month English
Form and Instruction
NA
Ages and Stages Questionnaire - 2 month Spanish
Form and Instruction
NA
Ages and Stages Questionnaire - 24 month English
Form and Instruction
NA
Ages and Stages Questionnaire - 24 month Spanish
Pregnant Women - Ages and Stages 6 Month Questionnaire
Removed
0
0
0
Form and Instruction
NA
Ages and Stages Questionnaire - 6 month English
Form and Instruction
NA
Ages and Stages Questionnaire - 6 month Spanish
Form and Instruction
NA
Ages and Stages Questionnaire - 4 month English
Form and Instruction
NA
Ages and Stages Questionnaire - 4 month Spanish
Pregnant Women - Ages and Stages: 12 and 24 Month Questionnaire
New
1800
450
0
Form and Instruction
NA
Ages and Stages Questionnaire - 12 month English
Form and Instruction
NA
Ages and Stages Questionnaire - 12 month Spanish
Form and Instruction
NA
Ages and Stages Questionnaire - 24 month English
Form and Instruction
NA
Ages and Stages Questionnaire - 24 month Spanish
Pregnant Women - Infant Symptoms Questionnaire
Unchanged
31500
5250
0
Form
none
ZEN Colombia: Infant Symptoms - English
Form
NA
ZEN Columbia: Infant Symptoms - Spanish 08SEP2017
Pregnant Women - Pregnant Women Eligibility Questionnaire
Modified
600
50
0
Form and Instruction
NA
ZEN Columbia: Pregnant Women Eligibility - English 08SEP2017
Form and Instruction
NA
ZEN Columbia: Pregnant Women Eligibility - Spanish 08SEP2017
Pregnant Women - Pregnant Women Enrollment Questionnaire
Modified
500
292
0
Form and Instruction
NA
ZEN Columbia - Pregnant Woman Enrollment Questionnaire - English 26MAY2017
Form and Instruction
NA
ZEN Columbia: Pregnant Women Enrollment Questionnaire - Spanish 08SEP2017
Pregnant Women - Pregnant Women Follow-Up Questionnaire
Modified
4000
1000
0
Form and Instruction
NA
ZEN Columbia: Pregnant Women Follow-Up Questionnaire - English 08SEP2017
Form and Instruction
NA
ZEN Columbia: Pregnant Women Follow-Up Questionnaire - Spanish 08SEP2017
Strengths and Difficulties Questionnaire
New
900
75
0
Form
NA
Strengths and Difficulties Assessment - ENGLISH
Form
NA
Strengths and Difficulties Assessment - SPANISH
Test of Nonverbal Intelligence
New
900
300
0
Form
NA
Standardized Infant Assessments
Total burden requested under this ICR:
71450
14211
0
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