Information Collection

Postpartum Survey - 6, 9, 12 months

IC 201791 under ICR 201302-0923-002 · OMB 0923-0046.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0046 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Postpartum Survey - 6, 9, 12 months	Form
Postpartum Survey for Mothers; 6, 9, and 12 months Attach 3f Postpart 6 9 12Mo 2-6-13.docx	Form

IC Title:

Postpartum Survey - 6, 9, 12 months

Agency IC Tracking Number:

18768

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	none	Postpartum Survey for Mothers; 6, 9, and 12 months	Attach 3f Postpart 6 9 12Mo 2-6-13.docx		No		Printable Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title: Records of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances

FR Citation: 57 FR 62812

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	375	375
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.