Information Collection

After You Deliver

IC 184007 under ICR 200803-0584-002 · OMB 0584-0524.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0524 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2-19-08ScreeningQuestionnaireEnglish_OMB_-FINAL.pdf	Other-Questionnaire
2-19-08ScreeningQuestionnaireSpanish_OMB_-FINAL.pdf	Other-Questionnaire
2-19-08ModeratorGuideEnglish_OMB_-FINAL v2.pdf	Other-Interview Guide English
2-19-08ModeratorGuideSpanish_OMB_-FINAL v2.pdf	Other-Interview Guide Spanish
After You Deliver ConfidentialityForm.pdf	Other-Confidentiality Statement Engl
After You Deliver ConfidentialityForm-Spanish.pdf	Other-Confidentiality Statement Span

IC Title:

After You Deliver

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Questionnaire	2-19-08ScreeningQuestionnaireEnglish_OMB_-FINAL.pdf	No	Paper Only
Other-Questionnaire	2-19-08ScreeningQuestionnaireSpanish_OMB_-FINAL.pdf	No	Paper Only
Other-Interview Guide English	2-19-08ModeratorGuideEnglish_OMB_-FINAL v2.pdf	No	Paper Only
Other-Interview Guide Spanish	2-19-08ModeratorGuideSpanish_OMB_-FINAL v2.pdf	No	Paper Only
Other-Confidentiality Statement English	After You Deliver ConfidentialityForm.pdf	No	Paper Only
Other-Confidentiality Statement Spanish	After You Deliver ConfidentialityForm-Spanish.pdf	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 214

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	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	214	0	0	0	0	0
Annual IC Time Burden (Hours)	186	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
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.