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Federal forms, ICRs, and supporting documents

Information Collection

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

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

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Redesigned Preconception, Pregnancy and Parenting (3P's) Information Forms 3-6
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL 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

Health Health Care Services

 

20,337 0
   
Individuals or Households
 
   75 %

  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 20,337 0 20,337 0 0 0
Annual IC Time Burden (Hours) 20,337 0 20,337 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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