PRAMS Supplemental Modules

Pregnancy Risk Assessment Monitoring System (PRAMS)

OMB: 0920-1273

IC ID: 236588

Information Collection (IC) Details

View Information Collection (IC)

PRAMS Supplemental Modules
 
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 Family History of Breast and Ovarian Cancer Supplement Att 10a-Family History Breast Ovarian Cancer Supp_English_Spanish.docx No   Paper Only
Form and Instruction n/a Prescription and Illicit Opioid Use Supplement Att 10b-Opioids Supplement_English_Spanish_mail and phone.docx No   Paper Only
Form and Instruction n/a Disabilities Supplement Att 10c-Disability Supplement_English_Spanish_mail and phone.docx No   Paper Only

Health Public Health Monitoring

09-20-0160 Records of Subjects in Health Promotion and Education Studies  51 FR 42484

61,253 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 61,253 0 0 0 0 61,253
Annual IC Time Burden (Hours) 5,104 0 0 0 0 5,104
Annual IC Cost Burden (Dollars) 125,262 0 0 0 0 125,262

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

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