Pregnant Women - Ages and Stages 6 Month Questionnaire

ZEN Colombia Study: Zika in Pregnant Women and Children in Colombia

OMB: 0920-1190

IC ID: 226998

Information Collection (IC) Details

View Information Collection (IC)

Pregnant Women - Ages and Stages 6 Month Questionnaire
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Ages and Stages Questionnaire - 6 month English Att B9_Ages and Stages-6_Months.pdf NA No   Paper Only
Form and Instruction NA Ages and Stages Questionnaire - 6 month Spanish Att C9-Ages and Stages-6_Month_spanish.pdf NA No   Paper Only
Form and Instruction NA Ages and Stages Questionnaire - 4 month English Att B9_Ages and Stages-4_Months.pdf NA No   Paper Only
Form and Instruction NA Ages and Stages Questionnaire - 4 month Spanish Att C9-Ages and Stages-4_Month_spanish.pdf NA No   Paper Only

Health Public Health Monitoring

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

2,250 0
   
Individuals or Households
 
   0 %

  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 0 0 -2,250 0 0 2,250
Annual IC Time Burden (Hours) 0 0 -563 0 0 563
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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