Document Name Document Type
Assessing the Needs and Capacity of State Newborn Screening Programs and Laboratories Form
Newborn Screening Lab Survey NBS Attachment G Newborn Screening LABORATORY data collection instrument survey monkey version.pdf Form
Newborn Screening Program Survey NBS Attachment I Newborn Screening PROGRAM data collection instrument survey monkey version.pdf Form
NBS Supporting_Statement_B_01092013.docx Supporting Statement B IC Document
NBS Supporting_Statement_A 01102013.docx Supporting Statement A IC Document
NBS Attachment E Recommended Uniform Screening Panel.pdf Att E - Recommended Screening Panel IC Document
NBS Attachment C Newborn Screening Saves Lives Act 2007.pdf Att C - Newborn Screening Act IC Document
NBS Attachment A CDC Grand Rounds Newborn Screening MMWR.pdf Att A - MMWR Newborn Screening IC Document
NBS Attachment B 30 Years Improving and Assuring NBS Quality at CDC.pdf Att B - Newborn Screening article IC Document
NBS Attachment D SACHDNC summary report 2011.pdf Att D - Report to Congress IC Document
NBS Attachment N Reminder e-mail for PROGRAM nonresponders.docx Att N - Reminder email IC Document
NBS Attachment O Reminder e-mail for LABORATORY nonresponders.docx Att O - Reminder email IC Document
NBS Attachment M APHL Reminder.docx Att M - Reminder in APHL IC Document
NBS Attachment L APHL Notice.docx Att L - Invite letter IC Document
NBS Attachment J Email letter of invitation of newborn screening PROGRAM directors.docx Att J - Invite Letter IC Document
NBS Attachment K Email letter of invitation of newborn screening LABORATORY directors.docx Att K - Invite Letter IC Document
NBS Attachment H Newborn Screening PROGRAM data collection instrument ms word version.docx Att H - Program survey - Word IC Document
NBS Attachment F Newborn Screening LABORATORY data collection instrument ms word version.docx Att F - Lab survey - Word IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Assessing the Needs and Capacity of State Newborn Screening Programs and Laboratories	Agency IC Tracking Number:

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	none	Newborn Screening Lab Survey	NBS Attachment G Newborn Screening LABORATORY data collection instrument survey monkey version.pdf		Yes	Yes	Fillable Fileable
Form	none	Newborn Screening Program Survey	NBS Attachment I Newborn Screening PROGRAM data collection instrument survey monkey version.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 88	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	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	88	0	0	0	0	0
Annual IC Time Burden (Hours)	45	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement B	NBS Supporting_Statement_B_01092013.docx	01/16/2013
Supporting Statement A	NBS Supporting_Statement_A 01102013.docx	01/16/2013
Att E - Recommended Screening Panel	NBS Attachment E Recommended Uniform Screening Panel.pdf	01/16/2013
Att C - Newborn Screening Act	NBS Attachment C Newborn Screening Saves Lives Act 2007.pdf	01/16/2013
Att A - MMWR Newborn Screening	NBS Attachment A CDC Grand Rounds Newborn Screening MMWR.pdf	01/16/2013
Att B - Newborn Screening article	NBS Attachment B 30 Years Improving and Assuring NBS Quality at CDC.pdf	01/16/2013
Att D - Report to Congress	NBS Attachment D SACHDNC summary report 2011.pdf	01/16/2013
Att N - Reminder email	NBS Attachment N Reminder e-mail for PROGRAM nonresponders.docx	01/16/2013
Att O - Reminder email	NBS Attachment O Reminder e-mail for LABORATORY nonresponders.docx	01/16/2013
Att M - Reminder in APHL	NBS Attachment M APHL Reminder.docx	01/16/2013
Att L - Invite letter	NBS Attachment L APHL Notice.docx	01/16/2013
Att J - Invite Letter	NBS Attachment J Email letter of invitation of newborn screening PROGRAM directors.docx	01/16/2013
Att K - Invite Letter	NBS Attachment K Email letter of invitation of newborn screening LABORATORY directors.docx	01/16/2013
Att H - Program survey - Word	NBS Attachment H Newborn Screening PROGRAM data collection instrument ms word version.docx	01/16/2013
Att F - Lab survey - Word	NBS Attachment F Newborn Screening LABORATORY data collection instrument ms word version.docx	01/16/2013

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

Assessing the Needs and Capacity of State Newborn Screening Programs and Laboratories

Surveys of State, Tribal, Local and Territorial (STLT) Governmental Health Agencies

OMB: 0920-0879

IC ID: 205467

View Information Collection (IC)