Information Collection

Pregnancy Visit 1 Interview (PB, EH, TT-HI, PBS)

IC 193565 under ICR 201205-0925-002 · OMB 0925-0593.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0593 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 8.1 Pregnancy Visit 1 Interview (PB, EH, TT-HI, PBS)	Form and Instruction
8.1 Survey Pregnancy Visit 1 Interview 20120413.docx	Form and Instruction
8.2 Survey Pregnancy Visit 1 SAQ 20120413.docx	Form and Instruction
Pregnancy Visit 1 Visit Information Sheet.docx Pregnancy Visit 1 Visit Information Sheet	IC Document

IC Title:

Pregnancy Visit 1 Interview (PB, EH, TT-HI, PBS)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	8.1	Survey	Pregnancy Visit 1 Interview 20120413.docx		Yes	Yes	Paper Only
Form and Instruction	8.2	Survey	Pregnancy Visit 1 SAQ 20120413.docx		Yes	Yes	Paper Only

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,018

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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,018	-3,092	5,110
Annual IC Time Burden (Hours)	1,177	-3,933	5,110
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Pregnancy Visit 1 Visit Information Sheet	Pregnancy Visit 1 Visit Information Sheet.docx	04/13/2012

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