Att 5_Screening Call Script -- Part B (eligibles only)

Assessment & Monitoring of Breastfeeding-Related Maternity Care Practices in Intrapartum Care Facilities in the United States and Territories

Documents and Forms

Document Name Document Type
Form 0920-0743 Att 5_Screening Call Script -- Part B (eligibles only) Form
0920-0743 Screening Telephone Call to Identify the Appropriate Sur Attachment 4b Screening Call Script_Part B.docx Form
0920-0743 Screening Telephone Call to Identify the Appropriate Sur Attachment 4b Screening Call Script_Part B.docx Form
Attachment 5f Reminder Telephone Call Script.docx Reminder Telephone Call Script IC Document
Attachment 5f Reminder Telephone Call Script.docx Reminder Telephone Call Script IC Document

Information Collection (IC) Details

IC Title:	Att 5_Screening Call Script -- Part B (eligibles only)	Agency IC Tracking Number:	0920-0743

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-0743	Screening Telephone Call to Identify the Appropriate Survey Contact Person at Eligible Facilities	Attachment 4b Screening Call Script_Part B.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,847	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,847	175	1,672
Annual IC Time Burden (Hours)	123	12	111
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Reminder Telephone Call Script	Attachment 5f Reminder Telephone Call Script.docx	09/29/2021

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