Contraceptive Assessment Questionnaire

Emergency Zika Package IV: Assessment of Contraceptive Use and Needs, Puerto Rico, 2016

OMB: 0920-1114

IC ID: 221550

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Contraceptive Assessment Questionnaire
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Consumer Health and Safety

09-20-0113 Epidemic Investigation Case Records  51 FR 42466

2,500 0
   
Individuals or Households
 
   100 %

  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 2,500 0 2,500 0 0 0
Annual IC Time Burden (Hours) 625 0 625 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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