Information Collection

CDC Newborn Screening Quality Assurance Program – Spinal Muscular Atrophy (SMA) Proficiency Testing (PT) Pilot

IC 242252 under ICR 201711-0920-012 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CDC Newborn Screening Quality Assurance Program – Spinal Muscular Atrophy (SMA) Proficiency Testing (PT) Pilot	Form and Instruction
NSQPA Pilot SMA PT Data Reporting Form AttA - Pilot SMA PT Data Reporting Form.xls	Form and Instruction
NSQAP Pilot SMA PT Program Customer Feedback Form AttB - Pilot SMA PT Feedback Form.xlsm	Form and Instruction
AttC - Pilot SMA PT Instructions.docx Instructions for the SMA PT Pilot	IC Document
AttD - Pilot SMA PT Email Invitation.docx Email Invitation to Public Health Lab	IC Document
AttF - Pilot SMA PT Email Reminder.pdf Email Reminder	IC Document
AttG - Pilot SMA PT Email Packet.docx Email Notification to Participating Labs about the PT Packet	IC Document
AttE - Pilot SMA PT Research Determination.pdf CDC Determination: IRB Approval is Not Required	IC Document
SMA-PT-SSA.docx Supporting Statement Part A	IC Document
SMA-PT-SSB.docx Supporting Statement Part B	IC Document

IC Title:

CDC Newborn Screening Quality Assurance Program â Spinal Muscular Atrophy (SMA) Proficiency Testing (PT) Pilot

Agency IC Tracking Number:

0920-20PK

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	NSQPA Pilot SMA PT Data Reporting Form	AttA - Pilot SMA PT Data Reporting Form.xls		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	NSQAP Pilot SMA PT Program Customer Feedback Form	AttB - Pilot SMA PT Feedback Form.xlsm		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	9	9
Annual IC Cost Burden (Dollars)	457	457

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Instructions for the SMA PT Pilot	AttC - Pilot SMA PT Instructions.docx	06/12/2020
Email Invitation to Public Health Lab	AttD - Pilot SMA PT Email Invitation.docx	06/12/2020
Email Reminder	AttF - Pilot SMA PT Email Reminder.pdf	06/12/2020
Email Notification to Participating Labs about the PT Packet	AttG - Pilot SMA PT Email Packet.docx	06/12/2020
CDC Determination: IRB Approval is Not Required	AttE - Pilot SMA PT Research Determination.pdf	06/12/2020
Supporting Statement Part A	SMA-PT-SSA.docx	06/15/2020
Supporting Statement Part B	SMA-PT-SSB.docx	06/15/2020

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