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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Audience Feedback to Inform the 7th Year Follow-Up Protocol of the Adolescent Brain and Cognitive Development (ABCD) Study
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
1
Teen Screener
AttC_ABCD_Teen_screener - Y7_Rev03623.docx
Yes
Yes
Fillable Fileable
Form and Instruction
2
Teen Assent Form
AttF_Y7_ABCD_Teen_Assent_Form_Rev030623.docx
Yes
Yes
Fillable Fileable
Form and Instruction
3
Teen Consent Form
AttG_Y7_ABCD_Teen_18_CONSENT_Form_Rev030623.docx
Yes
Yes
Fillable Fileable
Form and Instruction
4
Teen Pre-Discussion Survey
AttJ_ABCD Study 7YFP Teen pre-discussion survey_Rev030623.docx
Yes
Yes
Fillable Fileable
Form and Instruction
5
Teen Pre-Discussion Survey Screenshots
AttK_ABCD Study 7YFP Teen pre-discussion survey screenshots_Rev030623.docx
Yes
Yes
Fillable Fileable
Form and Instruction
6
Teen Moderators Guide
AttL_ABCD Study 7YFP Teen Moderators Guide_Rev030623.docx
Yes
Yes
Fillable Fileable
Other-Parent Moderators Guide Spanish Version
AttI_ABCD Study 7YFP Parent Moderators - SPANISH Rev030623.docx
Yes
Yes
Fillable Fileable
Form and Instruction
7
Parent/Caregiver Screener
AttA_ABCD_Parent_Screener_Y7_Rev030623.docx
Yes
Yes
Fillable Fileable
Other-Parent/Caregiver Screener, Spanish
AttB_ABCD_Parent_Screener_Y7_SPANISH_Rev030623.docx
Yes
Yes
Fillable Fileable
Form and Instruction
8
Parent Consent Form
AttD_Y7_ABCD_Parent_Consent_Form_Parent_English_Rev030623.docx
Yes
Yes
Fillable Fileable
Other-Parent Consent Form Spanish Version
AttE_Y7_ABCD_Parent_Consent_Form_Parent_SPANISH_Rev030623.docx
Yes
Yes
Fillable Fileable
Form and Instruction
9
Parent Moderators Guide
AttH_ABCD Study 7YFP Parent Moderators - Final English Rev030623.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
276
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
276
0
276
0
0
0
Annual IC Time Burden (Hours)
75
0
75
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Mini SSA
Mini SSA for Citizen Science - ABCD Y7 Audience Research Rev 030723 Clean.docx
03/08/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.