Parent Report (for children ages 4-17)

[NCBDDD] Documenting Outcomes Associated with Persistent Tic Disorders (Including Tourette Syndrome) in Children, Adolescents, and Young Adults Through Surveillance

Documents and Forms

Document Name Document Type
Parent Report (for children ages 4-17) Form and Instruction
Parent Form Att 4_Parent forms.pdf Form and Instruction
Parent Form Att_4 Parent forms.pdf Form and Instruction
Att 9_Parent Forms in REDCap.pdf Parent Form Redcap copy IC Document
Att 9_Parent Forms in REDCap.pdf Parent Form Redcap copy IC Document

Information Collection (IC) Details

IC Title:	Parent Report (for children ages 4-17)	Agency IC Tracking Number:	0920-24EG

Is this a Common Form? No		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	n/a	Parent Form	Att_4 Parent forms.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62811

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	225	225
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Parent Form Redcap copy	Att 9_Parent Forms in REDCap.pdf	09/22/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.