36-Month Interview

Continuation of National Children's Study Vanguard (Pilot) Study Data Collection: Study Visits through 60-Months

OMB: 0925-0593

IC ID: 210030

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

36-Month Interview
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 38.2 Survey 36M_42MonthASQ3.docx Yes Yes Paper Only
Form and Instruction 38.3 Survey SWANRatingScaleADHDSAQ.docx Yes Yes Paper Only
Form and Instruction 38.4 Survey EarlyChildHoodCognitionBattery_NIHToolbox.docx Yes Yes Paper Only
Form and Instruction 38.5 Survey 36M_AlcoholTobaccoSubstanceAbuseCASI.docx Yes Yes Paper Only
Form and Instruction 38.6 Survey 36M_WomanAbuseScreeningToolCASI.docx Yes Yes Paper Only
Form and Instruction 38.7 Survey MajorLifeEventsSAQ.docx Yes Yes Paper Only
Form and Instruction 38.9 Survey 36MQuestionnaireAdult.docx Yes Yes Paper Only
Form and Instruction 38.10 Survey 36MQuestionnaireHousehold.docx Yes Yes Paper Only
Form and Instruction 38.11 Survey 36MQuestionnaireChildCare.docx Yes Yes Paper Only
Form and Instruction 38.1 Survey 36MonthASQ3.docx Yes Yes Paper Only
Form and Instruction 38.12 Revised Survey 36MQuestionnaireChild_REVISED.docx Yes Yes Paper Only

General Science and Innovation Scientific and Technological Research and Innovation

 

1,711 0
   
Individuals or Households
 
   0 %

  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 1,711 0 0 0 0 1,711
Annual IC Time Burden (Hours) 2,873 0 0 0 0 2,873
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
ASQ3InPersonMailInstructions ASQ3InPersonMailInstructions.docx 11/07/2013
SWANBehaviorRatingScalesInstructions SWANBehaviorRatingScalesInstructions.docx 11/07/2013
MajorLifeEventsInstructions MajorLifeEventsInstructions.docx 11/07/2013
36M_HomeSocialDirectObservationInstrument 36M_HomeSocialDirectObservationInstrument.docx 11/08/2013
HIPAAHealthUseDisclosureAuthorizationForm HIPAAHealthUseDisclosureAuthorizationForm.docx 01/15/2014
InformedConsentFormAdult InformedConsentFormAdult.docx 01/15/2014
MultiModeVisitInformationScript MultiModeVisitInformationScript.docx 01/15/2014
ParentalPermissionChildParticipation6MonthtoAgeMajority ParentalPermissionChildParticipation6MonthtoAgeMajority.docx 01/15/2014
ReconsiderationQuestionnaireAdult ReconsiderationQuestionnaireAdult.docx 01/15/2014
ReconsiderationQuestionnaireChild ReconsiderationQuestionnaireChild.docx 01/15/2014
SampleCollectionVIS SampleCollectionVIS.docx 01/15/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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