Supplemental CATI about Stillbirth

Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS)

OMB: 0920-0010

IC ID: 222820

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Supplemental CATI about Stillbirth
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Introductory Phone Script for the Interview about Stillborth (English) Att45_BD2_StillbirthPilot_IntroPhoneScript_English_4.30.2019_CLEAN_v1_FINAL.docx Yes Yes Fillable Fileable
Form and Instruction n/a Introductory Phone Script for the Interview about Stillborth (Spanish) Att45_BD2_StillbirthPilot_IntroPhoneSpan-Proofread 12-28-20-Clean_New_1.6.2021.docx Yes Yes Fillable Fileable
Form and Instruction n/a Computer Assisted Phone Interview about Stillbirth (English) AttJ1_BDSTEPS_SB-Suppl Quest.docx Yes Yes Fillable Fileable
Form and Instruction n/a Computer Assisted Phone Interview about Stillbirth (Spanish) AttJ2_BDSTEPS_SB-Suppl Quest_SPAN.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

640 0
   
Individuals or Households
 
   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 640 0 0 0 0 640
Annual IC Time Burden (Hours) 267 0 0 0 0 267
Annual IC Cost Burden (Dollars) 2,667 0 0 0 0 2,667

Title Document Date Uploaded
Introductory Letter for the Supplemental Interview about Stillbirth (English) AttO1_SB-Suppl_IntroLetter.docx 08/26/2019
Introductory Letter for the Supplemental Interview about Stillbirth (Spanish) AttO2_SB-Suppl_IntroLetter_SPAN.docx 08/26/2019
Thankyou Letter for the Supplemental Interview about Stillbirth (English) Att44_BD2_SBSupp_ThankYou_SuppInterview_completed_at_later_date_08_31_2020_Clean.docx 01/21/2021
Thankyou Letter for the Supplemental Interview about Stillbirth (Spanish) Att44_BD2_SBSupp_ThankYou_SuppInterview_completed_at_later_date_083120_Span_Proofread 12-28-20-clean.docx 01/21/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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