Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Adult Questionnaire Modified 2333 1167 29139
Appointment Reminder Unchanged 3033 253 6312 Form and Instruction n/a
Blood Draw and Urine Collection Unchanged 3033 506 12626 Form and Instruction n/a
Body and Blood Pressure Measures Unchanged 3033 253 6312 Form and Instruction n/a
Child Neurobehavioral Test Battery Unchanged 700 1050 26229 Form and Instruction n/a
Child Questionnaire - Long Form Modified 560 280 6994
Child Questionnaire - Short Form Modified 140 35 874 Form and Instruction n/a
Child School Record Abstraction Unchanged 720 240 5386 Form and Instruction n/a
Drinking Water Information Collection (Environmental Protection Agencies) New 7 49 1186 Form and Instruction n/a
Drinking Water Information Collection (Public Water Purveyors) New 14 140 3331 Form and Instruction n/a
Eligibility Screening Unchanged 7982 1330 33231 Form and Instruction n/a
Medical Record Abstraction - Adult Unchanged 2400 800 16927 Form and Instruction n/a
Medical Record Abstraction - Child Unchanged 700 233 4935 Form and Instruction n/a
Medication List Unchanged 3033 152 3788 Form and Instruction n/a
Parent Neurobehavioral Test Battery Unchanged 700 175 4372 Form and Instruction n/a
Request for Child School Record Abstraction Modified 690 230 10730 Other-Letter of Request to School Administrator with Study Information
Request for Medical Record Abstraction Unchanged 3010 1003 54860 Other-Letter of Request to Provider with Study Information
Update Contact Information Unchanged 3033 253 6312 Form and Instruction n/a
Total burden requested under this ICR: 35121 8149 233544  
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