Telephone Screening Interview for Hospitals

Assessment & Monitoring of Breastfeeding-Related Maternity Care Practices in Intrapartum Facilitie

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0743 can be found here:

Documents and Forms

Document Name Document Type
Form G-1 Telephone Screening Interview for Hospitals Form
G-1 Telephome Screening Interview - Hospitals Appendix_G-1_Telephone_Screening_Interview_-_Hospitals(2).doc Form

Information Collection (IC) Details

IC Title:	Telephone Screening Interview for Hospitals	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	G-1	Telephome Screening Interview - Hospitals	Appendix_G-1_Telephone_Screening_Interview_-_Hospitals(2).doc		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,897	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,897	981	2,916
Annual IC Time Burden (Hours)	325	82	243
Annual IC Cost Burden (Dollars)	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.