Information Collection

Redesigned Preconception, Pregnancy and Parenting (3P's) Information Forms 3-6

IC 223581 under ICR 201609-0915-003 · OMB 0915-0338.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0338 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form B3 B3 3Ps_Preconception Form_revised.doc Redesigned Preconception, Pregnancy and Parenting (3P's) Information Forms 3-6	Form and Instruction
Form B4 B4 3Ps_Prenatal Form_revised.doc Redesigned Preconception, Pregnancy and Parenting (3P's) Information Forms 3-6	Form and Instruction
Form B5 B5 3Ps_Postpartum Form_revised.doc Redesigned Preconception, Pregnancy and Parenting (3P's) Information Forms 3-6	Form and Instruction
Form B6 B6 3Ps_Interconception_Parenting Form_revised.doc Redesigned Preconception, Pregnancy and Parenting (3P's) Information Forms 3-6	Form and Instruction
B3 B3 3Ps_Preconception Form_revised.doc B3. 3Ps_Preconception Form_revised.doc	Form and Instruction
B4 B4 3Ps_Prenatal Form_revised.doc B4. 3Ps_Prenatal Form_revised.doc	Form and Instruction
B5 B5 3Ps_Postpartum Form_revised.doc B5. 3Ps_Postpartum Form_revised.doc	Form and Instruction
B6 B6 3Ps_Interconception_Parenting Form_revised.doc B6. 3Ps_Interconception_Parenting Form_revised.doc	Form and Instruction

IC Title:

Redesigned Preconception, Pregnancy and Parenting (3P's) Information Forms 3-6

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	B3	B3 3Ps_Preconception Form_revised.doc	B3. 3Ps_Preconception Form_revised.doc	Yes	Yes	Fillable Fileable
Form and Instruction	B4	B4 3Ps_Prenatal Form_revised.doc	B4. 3Ps_Prenatal Form_revised.doc	Yes	Yes	Fillable Fileable
Form and Instruction	B5	B5 3Ps_Postpartum Form_revised.doc	B5. 3Ps_Postpartum Form_revised.doc	Yes	Yes	Fillable Fileable
Form and Instruction	B6	B6 3Ps_Interconception_Parenting Form_revised.doc	B6. 3Ps_Interconception_Parenting Form_revised.doc	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20,337

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20,337	20,337
Annual IC Time Burden (Hours)	20,337	20,337
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.