Epidemiologist - Pregnancy Module

SARS-CoV-2 Epidemiologic Data Collections

OMB: 0920-1297

IC ID: 241645

Information Collection (IC) Details

View Information Collection (IC)

Epidemiologist - Pregnancy Module
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Pregnancy Module 11. Pregnancy Module Supplement_Instrument_OMB.pdf NA Yes Yes Fillable Fileable
Form and Instruction 0920-1297 Pregnancy Module - Pregnant Women/Neonate Form) REVISED 16SEP2020 COVID-19_Pregnancy_Module_V2.0_Final 16-Sep-2020_Updated.docx NA Yes Yes Fillable Fileable

Disaster Management Emergency Response

Epidemiologic Studies and Surveillance of Disease Problems  57 FR 92812

15 0
   
State, Local, and Tribal Governments
 
   100 %

  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 29,250 0 9,250 0 0 20,000
Annual IC Time Burden (Hours) 14,625 0 -375 0 0 15,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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