Information Collection

Non-Medically Indicated Induction Prior to 39 Weeks of Gestation Focus Groups

IC 201950 under ICR 201110-0925-003 · OMB 0925-0643.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0643 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2 Non-Medically Indicated Induction Prior to 39 Weeks of Gestation Focus Groups	Form and Instruction
2 Focus Group fathers Pre-term_Birth_Telephone_Focus_Group_Guide_fathers_0925-0643_rev 4-10-12.docx	Form and Instruction
1 Screener Pre-term_birth_recruitment_screener_0925-0643.docx	Form and Instruction
3 Pregnant Women Pre-term_Birth_Telephone_Focus_Group_Guide_pregnant_women_0925-0643_rev 4-10-12.docx	Form and Instruction
Generic Template_OMB_preterm_birth_project_0925-0643[1].docx Generic Template_OMB_preterm_birth_project_0925-0643[1]	IC Document

IC Title:

Non-Medically Indicated Induction Prior to 39 Weeks of Gestation Focus Groups

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	2	Focus Group fathers	Pre-term_Birth_Telephone_Focus_Group_Guide_fathers_0925-0643_rev 4-10-12.docx	Yes	Yes	Paper Only
Form and Instruction	1	Screener	Pre-term_birth_recruitment_screener_0925-0643.docx	Yes	Yes	Paper Only
Form and Instruction	3	Pregnant Women	Pre-term_Birth_Telephone_Focus_Group_Guide_pregnant_women_0925-0643_rev 4-10-12.docx	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 45

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	45	0	0	0	0	0
Annual IC Time Burden (Hours)	68	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
Generic Template_OMB_preterm_birth_project_0925-0643[1]	Generic Template_OMB_preterm_birth_project_0925-0643[1].docx	04/10/2012

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