Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Adult Questionnaire Modified 367 184 4584 Form none
Appointment Reminder Telephone Script Modified 542 45 1128 Form and Instruction none
Blood Draw and Urine Collection Form Modified 542 90 2256 Form none
Body and Blood Pressure Measures Form Modified 542 45 1128 Form none
Child Neurobehavioral Test Battery Modified 175 263 6557 Instruction
Child Questionnaire - Long Form Modified 140 70 1749 Form none
Child Questionnaire - Short Form Modified 35 9 219 Form none
Child School Record Abstraction Modified 180 60 1346 Form none
Medical Record Abstraction - Adult Modified 375 125 2645 Form none
Medical Record Abstraction - Child Modified 175 58 1234 Form none
Medication List Modified 542 27 677 Form none
Parent Neurobehavioral Test Battery Modified 175 44 1093 Instruction
Request for Child School Record Abstraction New 180 60 2799 Instruction
Request for Medical Record Abstraction New 550 183 10024 Instruction
Update Contact Information Hardcopy Form Modified 542 45 1128 Form none
Wave One Elligibility Screening Script Modified 612 102 2548 Form and Instruction none
Wave Three Eligibility Screening Script Modified 121 30 756 Form and Instruction none
Wave Two Eligibility Screening Script Modified 57 14 356 Form and Instruction none
Total burden requested under this ICR: 5852 1454 42227  
To view an IC, click on IC Title