PRAMS Phase 8 - Spanish

NCHS Questionnaire Design Research Laboratory

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:

Documents and Forms

Document Name Document Type
PRAMS Phase 8 - Spanish Form
PRAMS Phase 8 - Spanish Appendix 1 Qnne Spanish PRAMS final rev 101415.docx Form
Screener Appendix 3 rev Tele Screener Span PRAMS 101415.docx Form and Instruction
Respondent Data Sheet Appendix 5 Resp Data Collection Sheet Spanish PRAMS.docx Form
0920-0222 10-day PRAMS Spanish final rev 101415.docx Letter to Dr. Schwab IC Document
Appendix 2a-d Ad&Flyer Spanish PRAMS.docx Advertisement/Flyer IC Document
Appendix 4 Informed Consent Spanish PRAMS.docx Consent IC Document
Appendix 6 Thank You letter Spanish PRAMS.docx Thank you Letter IC Document

Information Collection (IC) Details

IC Title:	PRAMS Phase 8 - Spanish	Agency IC Tracking Number:	16BF

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	PRAMS Phase 8 - Spanish	Appendix 1 Qnne Spanish PRAMS final rev 101415.docx	Yes	Yes	Fillable Fileable
Form and Instruction	none	Screener	Appendix 3 rev Tele Screener Span PRAMS 101415.docx	Yes	Yes	Fillable Fileable
Form	none	Respondent Data Sheet	Appendix 5 Resp Data Collection Sheet Spanish PRAMS.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Health adn Demogrpahic Surveys Conducted in Probability Samples of the US Population	FR Citation: 49 FR 37693

Number of Respondents: 68	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	68	68
Annual IC Time Burden (Hours)	34	34
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Letter to Dr. Schwab	0920-0222 10-day PRAMS Spanish final rev 101415.docx	10/14/2015
Advertisement/Flyer	Appendix 2a-d Ad&Flyer Spanish PRAMS.docx	10/14/2015
Consent	Appendix 4 Informed Consent Spanish PRAMS.docx	10/14/2015
Thank you Letter	Appendix 6 Thank You letter Spanish PRAMS.docx	10/14/2015

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