Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Bayley Scales of Infant and Toddler Development Modified 4500 2250 0 Instruction
Center for Epidemiologic Studies Depression Scale Unchanged 4500 375 0 Form NA Center for Epidemiologic Studiesd Depression Scale
Male Partners - Adult Symptoms Questionnaire Unchanged 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 Unchanged 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 Unchanged 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 Modified 1000 83 0 Form none Parent Child Follow-up Eligibility Form
Form none Parent Child Follow-up Eligibility Form - Spanish
Parent-Child Enrollment Questionnaire Modified 900 225 0 Form and Instruction none Parent Child Enrollment Questionnaire
Form and Instruction none Parent Child Enrollment Questionnaire - Spanish
Parent-Child Follow-Up Questionnaire Modified 3600 600 0 Form none Parent Child Followup Questionnaire
Form none Parent Child Followup Questionnaire - Spanish
Parenting Stress Index IV Unchanged 4500 750 0 Form NA Standardized Infant Assessments
Peabody Developmental Motor Scales Unchanged 900 450 0 Form NA Standardized Infant Assessments
Pregnant Women - Adult Symptoms Questionnaire Unchanged 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 Unchanged 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: 12 and 24 Month Questionnaire Unchanged 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 Unchanged 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 Unchanged 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 Unchanged 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 Unchanged 900 75 0 Form NA Strengths and Difficulties Assessment - ENGLISH
Form NA Strengths and Difficulties Assessment - SPANISH
Test of Nonverbal Intelligence Unchanged 900 300 0 Form NA Standardized Infant Assessments
Total burden requested under this ICR: 73250 14736 0  
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