PRAMS Opioid Call-back Surveys

Pregnancy Risk Assessment Monitoring System (PRAMS)

OMB: 0920-1273

IC ID: 236589

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Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
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Information Collection (IC) Details

View Information Collection (IC)

PRAMS Opioid Call-back Surveys
 
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 PRAMS Opioid Call-back Survey (English) Att 11a-PRAMS Opioid Call Back Survey_DRAFT_PHONE_ENGLISH_040819.docx No   Paper Only
Form and Instruction n/a PRAMS Opioid Call-back Survey (Spanish) Att 11b-PRAMS Opioid Call Back Survey_DRAFT_PHONE_SPANISH_040819.docx No   Paper Only

Health Public Health Monitoring

09-20-0160  51 FR 42484

3,961 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 3,961 0 0 0 0 3,961
Annual IC Time Burden (Hours) 1,981 0 0 0 0 1,981
Annual IC Cost Burden (Dollars) 48,601 0 0 0 0 48,601

Title Document Date Uploaded
Call-back Survey Opt-out Recontact for Mail Survey (English) Att 13a-Call Back Survey Opt Out Recontact Mail_English.docx 06/20/2019
Call-back Survey Opt-out Recontact for Mail Survey (Spanish) Att 13b-Call Back Survey Opt Out Recontact Mail_Spanish.docx 06/20/2019
Call-back Survey Opt-out Recontact for Phone Survey (English) Att 13c-Call Back Survey Opt Out Recontact Phone_English.docx 06/20/2019
Call-back Survey Opt-out Recontact for Phone Survey (Spanish) Att 13d-Call Back Survey Opt Out Recontact Phone_Spanish.docx 06/20/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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