Att 6c_MPINC Facility Survey

Assessment & Monitoring of Breastfeeding-Related Maternity Care Practices in Intrapartum Care Facilities in the United States and Territories

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0743 can be found here:

Documents and Forms

Document Name Document Type
Att. 6c mPINC Facility Survey.doc Other-WORD
0920-0743 CDC mPINC Hospital Suvey (Maternity Practices in Infant Att. 3m Screenshots mPINC Survey.docx Form and Instruction
Att. 6a Survey Cover Letter paper.docx Att 6a_Survey Cover Letter IC Document
Att. 6b Survey Cover Letter email.docx Att 6b_Survey Cover Letter (E-mail) IC Document
Att. 6d Reminder (paper).docx Att 6d_Reminder IC Document
Att. 6e Reminder (e-mail).docx Att 6e_Reminder (e-mail) IC Document
Att. 6f Non-Responder Follow-Up.docx Att 6f_Non-Responder Follow-Up IC Document
Att. 6g Non-Responder Script.docx Att 6g_Non-Responder Script IC Document
Att. 6h Returned Surveys paper.docx Att 6h_Returned Surveys IC Document
Att. 6i Returned Surveys e-mail.docx Att 6i_Returned Surveys (E-mail) IC Document

Information Collection (IC) Details

IC Title:	Att 6c_MPINC Facility Survey	Agency IC Tracking Number:	0920-0743

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
Other-WORD			Att. 6c mPINC Facility Survey.doc		No		Paper Only
Form and Instruction	0920-0743	CDC mPINC Hospital Suvey (Maternity Practices in Infant Nutrition and Care 2018)	Att. 3m Screenshots mPINC Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,421	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,421	1,421
Annual IC Time Burden (Hours)	711	711
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att 6a_Survey Cover Letter	Att. 6a Survey Cover Letter paper.docx	08/14/2018
Att 6b_Survey Cover Letter (E-mail)	Att. 6b Survey Cover Letter email.docx	08/14/2018
Att 6d_Reminder	Att. 6d Reminder (paper).docx	08/14/2018
Att 6e_Reminder (e-mail)	Att. 6e Reminder (e-mail).docx	08/14/2018
Att 6f_Non-Responder Follow-Up	Att. 6f Non-Responder Follow-Up.docx	08/14/2018
Att 6g_Non-Responder Script	Att. 6g Non-Responder Script.docx	08/14/2018
Att 6h_Returned Surveys	Att. 6h Returned Surveys paper.docx	08/14/2018
Att 6i_Returned Surveys (E-mail)	Att. 6i Returned Surveys e-mail.docx	08/14/2018

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