Survey of Food Safety and Nutrition Information Provided to Pregnant Women by Health Care Providers and WIC Educators

Documents and Forms

Document Name Document Type
HCP food safety draft survey instrument 3-19-07.doc Other-Survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Survey of Food Safety and Nutrition Information Provided to Pregnant Women by Health Care Providers and WIC Educators	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
Other-Survey			HCP food safety draft survey instrument 3-19-07.doc		No	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16	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 Agency Discretion
Annual Number of Responses for this IC	16	16
Annual IC Time Burden (Hours)	12	12
Annual IC Cost Burden (Dollars)	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.