Women's Health Needs STUDY_QUESTIONNAIRE

Women’s Health Needs Study: The Health of US-Resident Women from Countries with Prevalent Female Genital Mutilation/Cutting (FGM/C)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1264 can be found here:

Documents and Forms

Document Name Document Type
Att H2 WHNS_Questionnaire (Somali Translations)_REVISED.docx Other-WORD Somali translations
Att H4 WHNS_Questionnaire (Arabic Translations)_REVISED.docx Other-WORD Arabic translations
Att H5 WHNS_Questionnaire (Amharic Translations)_REVISED.docx Other-WORD Armharic translations
Att H3 WHNS_Questionnaire (French Translations)_NEW.docx Other-WORD: French Translation
Att H6 WHNS_Questionnaire (Tigrinya Translations)_NEW.docx Other-WORD: Tigrinya Translation
0920-1264 Women's Health Need Study (revised) Att H1 WHNS_Questionnaire (English)_Clean.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Women's Health Needs STUDY_QUESTIONNAIRE	Agency IC Tracking Number:	0920-20OZ

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	Available Electronically?	Electronic Capability
Other-WORD Somali translations			Att H2 WHNS_Questionnaire (Somali Translations)_REVISED.docx	No	Paper Only
Other-WORD Arabic translations			Att H4 WHNS_Questionnaire (Arabic Translations)_REVISED.docx	No	Paper Only
Other-WORD Armharic translations			Att H5 WHNS_Questionnaire (Amharic Translations)_REVISED.docx	No	Paper Only
Other-WORD: French Translation			Att H3 WHNS_Questionnaire (French Translations)_NEW.docx	No	Paper Only
Other-WORD: Tigrinya Translation			Att H6 WHNS_Questionnaire (Tigrinya Translations)_NEW.docx	No	Paper Only
Form and Instruction	0920-1264	Women's Health Need Study (revised)	Att H1 WHNS_Questionnaire (English)_Clean.docx	No	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,000	1,600	400
Annual IC Time Burden (Hours)	500	200	300
Annual IC Cost Burden (Dollars)	0	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.