Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
Background and Demographic Information Form	Modified	45450	27270	0	Form and Instruction	2	Background Form
Background and Demographic Information Form	Modified	45450	27270	0	Form and Instruction	1	Demographic Form
Parent/Child Form	Modified	30300	15150	0	Form and Instruction	4_Revised	0915-0338_MCHB_HSMED_Parent Child Form_Redline_03052025
Prenatal Form	Unchanged	30300	6060	0	Form and Instruction	3	Prenatal Form
Prenatal Form	Unchanged	30300	6060	0	Form and Instruction	3_Revised	Prenatal Form (Revised)
Total burden requested under this ICR:		106050	48480	0
To view an IC, click on IC Title