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
Adult Questionnaire
Modified
2333
1167
29139
Form and Instruction
none
Adult questionnaire
Appointment Reminder
Unchanged
3033
253
6312
Form and Instruction
n/a
Appointment Reminder Telephone Script
Blood Draw and Urine Collection
Unchanged
3033
506
12626
Form and Instruction
n/a
Blood Draw and Urine Collection Form
Body and Blood Pressure Measures
Unchanged
3033
253
6312
Form and Instruction
n/a
Body and Blood Pressure Measures Form
Child Neurobehavioral Test Battery
Unchanged
700
1050
26229
Form and Instruction
n/a
Child/Parent Neurobehavioral Test Battery
Child Questionnaire - Long Form
Modified
560
280
6994
Form and Instruction
none
Child questionnaire - long form
Child Questionnaire - Short Form
Unchanged
140
35
874
Form and Instruction
n/a
Multi-site Study Child Questionnaire - Short Form
Child School Record Abstraction
Unchanged
720
240
5386
Form and Instruction
n/a
Multi-site Study Child School Record Abstraction Form
Drinking Water Information Collection (Environmental Protection Agencies)
Unchanged
7
49
1186
Form and Instruction
n/a
Water Information Collection Form for Environmental Protection Agencies
Drinking Water Information Collection (Public Water Purveyors)
Unchanged
14
140
3331
Form and Instruction
n/a
Drinking Water Information Collection Form for Public Water Purveyors
Eligibility Screening
Modified
7982
1330
33231
Form and Instruction
0923-0063
Eligibility Screening Script
Medical Record Abstraction - Adult
Unchanged
2400
800
16927
Form and Instruction
n/a
Multi-site Study Medical Record Abstraction Form - Adult
Medical Record Abstraction - Child
Unchanged
700
233
4935
Form and Instruction
n/a
Multi-site Study Medical Record Abstraction Form - Child
Medication List
Unchanged
3033
152
3788
Form and Instruction
n/a
Medication List
Parent Neurobehavioral Test Battery
Unchanged
700
175
4372
Form and Instruction
n/a
Child/Parent Neurobehavioral Test Battery
Request for Child School Record Abstraction
Unchanged
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
Update Contact Information Hardcopy Form
Total burden requested under this ICR:
35121
8149
233544
To view an IC, click on IC Title
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