Screening Telephone Call Script -- Part B (eligibles only)

Assessment & Monitoring of Breastfeeding-Related Maternity Care Practices in Intrapartum Care Facilities in the United States and Territories

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0743 can be found here:

Documents and Forms

Document Name Document Type
Appx G_Screening Telephone Call Script.docx Other-WORD
Appx H-1 Invitation Cover Letter (paper letter) 7 30 2013.docx Appx H-1 Invitation Cover Letter (paper letter) 7 30 2013 IC Document
Appx H-2 Invitation Cover Letter (email letter) 7 30 2013.docx Appx H-2 Invitation Cover Letter (email letter) 7 30 2013 IC Document

Information Collection (IC) Details

IC Title:	Screening Telephone Call Script -- Part B (eligibles only)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-WORD			Appx G_Screening Telephone Call Script.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,200	Number of Respondents for Small Entity: 259

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 56 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,200	2,200
Annual IC Time Burden (Hours)	147	147
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appx H-1 Invitation Cover Letter (paper letter) 7 30 2013	Appx H-1 Invitation Cover Letter (paper letter) 7 30 2013.docx	08/12/2013
Appx H-2 Invitation Cover Letter (email letter) 7 30 2013	Appx H-2 Invitation Cover Letter (email letter) 7 30 2013.docx	08/12/2013

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