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Federal forms, ICRs, and supporting documents

Information Collection

DD - POST-ENROLLMENT F/U Phone Call Script

IC 224186 under ICR 202102-0920-008 · OMB 0920-1171.

Documents and Forms
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Information Collection (IC) Details

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DD - POST-ENROLLMENT F/U Phone Call Script 16PA
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Att 23.d. ThankYouLetter_DD Completion Letter _SEED 3_3-7-17.doc No   Paper Only
Other-WORD Attachment 7.a. Pregnancy Reference Form Script SEED 3_9-19-16.doc No   Fillable Fileable
Other-WORD Attachment 7.b. Pregnancy Reference Form SEED 3_9_19_16.docx No   Fillable Fileable

Health Public Health Monitoring

 

158 0
   
Individuals or Households
 
   0 %

  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 158 0 0 0 0 158
Annual IC Time Burden (Hours) 40 0 0 0 0 40
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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