Recruitment Script - Zika Reproductive Health and Emergency Response Call-Back Survey (ZRHER), 2018

Zika Reproductive Health and Emergency Response Call-Back Survey, 2018

Documents and Forms

Document Name Document Type
Recruitment Script - Zika Reproductive Health and Emergency Response Call-Back Survey (ZRHER), 2018 Form and Instruction
Recruitment Script - ZRHER Att 4 ZRHER Recruitment Script.docx Form and Instruction
Recruitment Script - ZRHER Spanish Att 4S ZRHER Recruitment Script SPANISH.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Recruitment Script - Zika Reproductive Health and Emergency Response Call-Back Survey (ZRHER), 2018	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Recruitment Script - ZRHER	Att 4 ZRHER Recruitment Script.docx	NA	No		Paper Only
Form and Instruction	NA	Recruitment Script - ZRHER Spanish	Att 4S ZRHER Recruitment Script SPANISH.docx	NA	No		Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25,029	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	25,029	25,029
Annual IC Time Burden (Hours)	417	417
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.