Redesigned Preconception, Pregnancy and Parenting (3P's) Information Form: Pregnancy

National Healthy Start Evaluation and Quality Assurance

OMB: 0915-0338

IC ID: 223580

Information Collection (IC) Details

View Information Collection (IC)

Redesigned Preconception, Pregnancy and Parenting (3P's) Information Form: Pregnancy
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction B2 B2 3Ps_Pregnancy History Form_revised.doc B2. 3Ps_Pregnancy History Form_revised.doc Yes Yes Fillable Fileable

Health Health Care Services

 

40,675 0
   
Individuals or Households
 
   75 %

  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 -40,675 0 0 40,675
Annual IC Time Burden (Hours) 0 0 -6,915 0 0 6,915
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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