Provider-Based Sampling Frame Questionnaire (PBS)

Provider-Based Sampling Feasibility Study for the Vanguard (Pilot) Study and Data Collection Updates for the National Children's Study (NICHD)

OMB: 0925-0593

IC ID: 202207

Information Collection (IC) Details

View Information Collection (IC)

Provider-Based Sampling Frame Questionnaire (PBS)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2.3 Survey Provider Based Sampling Frame Questionnaire Worcester Co 20120413.docx Yes Yes Fillable Printable
Form and Instruction 2.1 Survey Provider Based Sampling Frame Questionnaire Harris Co 20120413.docx Yes Yes Fillable Printable
Form and Instruction 2.2 Survey Provider Based Sampling Frame Questionnaire Jefferson Co 20120413.docx Yes Yes Fillable Printable
Form and Instruction 2.4 Survey PBS Recruitment Response Form 20120413.docx Yes Yes Paper Only

General Science and Innovation Scientific and Technological Research and Innovation

 

50 0
   
Individuals or Households
 
   0 %

  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 50 0 50 0 0 0
Annual IC Time Burden (Hours) 21 0 21 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Advance Letter to Providers Advance Letter to Providers.docx 04/16/2012
Exemplar Letter to Accompany Questionnaire Exemplar Letter to Accompany Questionnaire.doc 04/16/2012
Advance Letter to Office Manager Provider Based Sampling Advance Letter to Office Manager.docx 04/16/2012
PBS Brochure Provider Based Sampling Brochure.docx 04/16/2012
Provider List Revision Letter Provider Based Sampling Provider List Revision Letter.doc 04/16/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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