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Strengths and Difficulties Questionnaire
ZEN Colombia Study: Zika in Pregnant Women and Children in Colombia
OMB: 0920-1190
IC ID: 229184
OMB.report
HHS/CDC
OMB 0920-1190
ICR 201803-0920-014
IC 229184
( )
Documents and Forms
Document Name
Document Type
Strengths and Difficulties Questionnaire
Form
Strengths and Difficulties Assessment - ENGLISH
Strengths and Difficulties ENGLISH.pdf
Form
Strengths and Difficulties Assessment - SPANISH
Strengths and Difficulties SPANISH.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Strengths and Difficulties Questionnaire
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
NA
Strengths and Difficulties Assessment - ENGLISH
Strengths and Difficulties ENGLISH.pdf
NA
No
Paper Only
Form
NA
Strengths and Difficulties Assessment - SPANISH
Strengths and Difficulties SPANISH.pdf
NA
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0113 - Epidemic Investigation Case Records System
FR Citation:
51 FR 42466
Number of Respondents:
900
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
900
0
0
0
0
900
Annual IC Time Burden (Hours)
75
0
0
0
0
75
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.