OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

ASD - POST ENROLLMENT _F/U Phone Call / Pregnancy Ref Form- (Mother)

IC 224013 under ICR 201610-0920-010 · OMB 0920-1171.

Documents and Forms
Document Name
Document Type
Other-WORD
Other-WORD
IC Document
Information Collection (IC) Details

View Information Collection (IC)

ASD - POST ENROLLMENT _F/U Phone Call / Pregnancy Ref Form- (Mother) 16PA
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Attachment 7.a. Pregnancy Reference Form Script SEED 3_9-19-16.doc Yes No Fillable Printable
Other-WORD Attachment 7.b. Pregnancy Reference Form SEED 3_9_19_16.docx No   Fillable Printable

Health Public Health Monitoring

09-20-0136: Epidemiologic Studies and Surveillance of Disease Problems   57 FR 62812

422 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 422 0 422 0 0 0
Annual IC Time Burden (Hours) 106 0 106 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att 21d_Follow-up Call Checklist Att 21.d. Follow-up Call Items Checklist SEED 3_3-7-17.docx 03/16/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.