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Survey of Knowledge, Attitudes and Practice Managment Patterns of Obstetricians Regarding Stillbirth Preganancy Outcomes
Survey of Knowledge, Attitudes and Practice Managment Patterns of Obstetricians Regarding Stillbirth Preganancy Outcomes
OMB: 0920-0742
IC ID: 178495
OMB.report
HHS/CDC
OMB 0920-0742
ICR 200701-0920-005
IC 178495
( )
Documents and Forms
Document Name
Document Type
Attach C_Stillbirth Management Provider Survey.doc
Instruction
Attach D_HHS_Letterhead(edits)12 11 2006.doc
Attach D_HHS_Letterhead(edits)12 11 2006
IC Document
Attach E_HHS letterhead.doc
Attach E_HHS letterhead
IC Document
Attach F_G_Sample_Reminder_Postcard1.doc
Attach F_G_Sample_Reminder_Postcard1
IC Document
Attach I Affidavit of Nondisclosure_draft_09 13 06.doc
Attach I Affidavit of Nondisclosure_draft_09 13 06
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Survey of Knowledge, Attitudes and Practice Managment Patterns of Obstetricians Regarding Stillbirth Preganancy Outcomes
Agency IC Tracking Number:
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
Instruction
Attach C_Stillbirth Management Provider Survey.doc
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
120
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
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
120
0
120
0
0
0
Annual IC Time Burden (Hours)
2
0
2
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attach D_HHS_Letterhead(edits)12 11 2006
Attach D_HHS_Letterhead(edits)12 11 2006.doc
01/09/2007
Attach E_HHS letterhead
Attach E_HHS letterhead.doc
01/09/2007
Attach F_G_Sample_Reminder_Postcard1
Attach F_G_Sample_Reminder_Postcard1.doc
01/09/2007
Attach I Affidavit of Nondisclosure_draft_09 13 06
Attach I Affidavit of Nondisclosure_draft_09 13 06.doc
01/09/2007
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.