Information Collection Request

Pregnancy Risk Assessment Monitoring System (PRAMS)

ICR 202211-0920-018 · OMB 0920-1273 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
PRAMS Stillbirth Phone Questionnaire (Spanish) Form and Instruction Modified Available
PRAMS Stillbirth Phone Questionnaire (English) Form and Instruction Modified Available
PRAMS Stillbirth Mail Questionnaire (Spanish) Form and Instruction Modified Available
PRAMS Stillbirth Mail Questionnaire (English) Form and Instruction Modified Available
PRAMS Stillbirth Survey Form and Instruction Modified Repair queued
PRAMS Field Testing Questionnaire (English and Spanish) Form and Instruction Modified Available
PRAMS Field Test Form and Instruction Modified Repair queued
PRAMS Opioid Call-back Survey (Spanish) Form and Instruction Modified Available
PRAMS Opioid Call-back Survey (English) Form and Instruction Modified Available
PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction Modified Repair queued
PRAMS Disabilities Supplement (web mode) Form and Instruction Modified Available
PRAMS Disabilities Supplement (mail and phone) Form and Instruction Modified Repair queued
PRAMS Marijuana Use Supplement (web mode) Form and Instruction Modified Available
PRAMS Marijuana Use Supplement (mail and phone) Form and Instruction Modified Available
PRAMS Opioid Use Supplement (web mode) Form and Instruction Modified Available
PRAMS Opioid Use Supplement (mail and phone) Form and Instruction Modified Available
PRAMS COVID-19 Experience Supplement (web mode) Form and Instruction Modified Available
PRAMS COVID-19 Experience Supplement (mail and phone) Form and Instruction Modified Available
PRAMS COVID-19 Vaccine Supplement (web mode) Form and Instruction Modified Available
PRAMS COVID-19 Vaccine Supplement (mail and phone) Form and Instruction Modified Available
PRAMS Social Determinants of Health Supplement (web mode) Form and Instruction Modified Available
PRAMS Social Determinants of Health Supplement (mail and phone) Form and Instruction Modified Available
PRAMS Supplemental Modules Form and Instruction Modified Repair queued
PRAMS Livebirth Phase 9 Standard Web Module (Spanish) Form and Instruction Modified Available
PRAMS Livebirth Phase 9 Standard Web Module (English) Form and Instruction Modified Available
PRAMS Livebirth Phase 9 Standard Phone Questionnaire (Spanish) Form and Instruction Modified Repair queued
PRAMS Livebirth Phase 9 Standard Phone Questionnaire (English) Form and Instruction Modified Repair queued
PRAMS Livebirth Phase 9 Standard Mail Questionnaire (Spanish) Form and Instruction Modified Available
PRAMS Livebirth Phase 9 Standard Mail Questionnaire (English) Form and Instruction Modified Repair queued
PRAMS Livebirth Phase 8 Standard Phone Module (Spanish) Form and Instruction Modified Available
PRAMS Livebirth Phase 8 Standard Phone Module (English) Form and Instruction Modified Available
PRAMS Livebirth Phase 8 Standard Mail Modules (Spanish) Form and Instruction Modified Available
PRAMS Livebirth Phase 8 Standard Mail Modules (English) Form and Instruction Modified Repair queued
PRAMS Livebirth Phase 9 Core Web Questionnaire (Spanish) Form and Instruction Modified Available
PRAMS Livebirth Phase 9 Core Web Questionnaire (English) Form and Instruction Modified Available
PRAMS Livebirth Phase 9 Core Phone Questionnaire (Spanish) Form and Instruction Modified Available
PRAMS Livebirth Phase 9 Core Phone Questionnaire (English) Form and Instruction Modified Available
PRAMS Livebirth Phase 9 Core Mail Questionnaire (Spanish) Form and Instruction Modified Available
PRAMS Livebirth Phase 9 Core Mail Questionnaire (English) Form and Instruction Modified Available
PRAMS Livebirth Phase 8 Core Phone Questionnaire (English) Form and Instruction Modified Available
PRAMS Livebirth Phase 8 Core Phone Questionnaire (English) Form and Instruction Modified Repair queued
PRAMS Livebirth Phase 8 Core Mail Questionnaire (Spanish) Form and Instruction Modified Available
PRAMS Livebirth Phase 8 Core Mail Questionnaire (English) Form and Instruction Modified Available
PRAMS Phase 8 Web Survey - WY Form and Instruction Modified Available
PRAMS Phase 8 Web Survey - VA Form and Instruction Modified Available
PRAMS Phase 8 Web Survey - SC Form and Instruction Modified Available
PRAMS Phase 8 Web Survey - PR Form and Instruction Modified Available
PRAMS Phase 8 Web Survey - MD Form and Instruction Modified Available
PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction Modified Repair queued
Att 2f - PRAMS Phase 8 Web Mode Data Collection Metrics.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 16 Summary of Changes between Phase 8 and 9.docx Supplementary Document Uploaded 2022-11-29 Missing upstream
Att 15a - PRAMS Field Testing Methodology.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 14 - PRAMS Live Birth Sample Size by Jurisdiction.xlsx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 13 - PRAMS IRB Approval_2022.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 12j - Livebirth Web Introduction and Informed Consent - SPANISH.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 12i - PRAMS Livebirth Web Introduction and Informed Consent - ENGLISH.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 12h - Stillbirth Phone Introduction and Informed Consent_SPANISH.docx Supplementary Document Uploaded 2022-11-29 Missing upstream
Att 12g - Stillbirth Phone Introduction and Informed Consent_ENGLISH.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 12f - PRAMS Livebirth Phone Introduction and Informed Consent - SPANISH.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 12e - PRAMS Livebirth Phone Introduction and Informed Consent - ENGLISH.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 12d - Stillbirth Mail Introduction and Informed Consent - SPANISH.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 12c - Stillbirth Mail Introduction and Informed Consent_ENGLISH.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 12b - PRAMS Livebirth Mail Introduction and Informed Consent - SPANISH.docx Supplementary Document Uploaded 2022-11-29 Missing upstream
Att 12a - PRAMS Livebirth Mail Introduction and Informed Consent - ENGLISH.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 7 - PRAMS Livebirth Phase 8 and Phase 9 Questionnaire Topic Reference.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 6 - PIDS Privacy Impact Assessment.pdf Supplementary Document Uploaded 2022-11-29 Repair queued
Att 5 - PRAMS Response Gifts and Rewards by Jurisdiction.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 4 - PRAMS Questionnaire Development Process.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 3b - Program Response to Comments 60 Day FRN.pdf Supplementary Document Uploaded 2022-11-29 Repair queued
Att 3a - Published 60 Day FRN.pdf Supplementary Document Uploaded 2022-11-29 Repair queued
Att 1c PREEMIE Reauthorization Act of 2018.pdf Supplementary Document Uploaded 2022-11-29 Repair queued
Att 1b Safe Motherhood and Infant Health Authorization.docx Supplementary Document Uploaded 2022-11-29 Repair queued
Att 1a-Section 301 of the Public Health Service Act (42 U.S.C. 241).docx Supplementary Document Uploaded 2022-11-29 Repair queued
PRAMS SS-B_30 Day_11-16-2022 clean.docx Supporting Statement B Uploaded 2022-11-29 Repair queued
1273 PRAMS SSA 11-16-2022 clean.docx Supporting Statement A Uploaded 2022-11-29 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
257195 Submission of Data File to CDC Instruction New
236591 PRAMS Stillbirth Survey Form and Instruction ModifiedPRAMS Stillbirth Phone Questionnaire (Spanish)
236591 PRAMS Stillbirth Survey Form and Instruction ModifiedPRAMS Stillbirth Phone Questionnaire (English)
236591 PRAMS Stillbirth Survey Form and Instruction ModifiedPRAMS Stillbirth Mail Questionnaire (Spanish)
236591 PRAMS Stillbirth Survey Form and Instruction ModifiedPRAMS Stillbirth Mail Questionnaire (English)
236591 PRAMS Stillbirth Survey Form and Instruction Modified
236590 PRAMS Field Test Form and Instruction ModifiedPRAMS Field Testing Questionnaire (English and Spanish)
236590 PRAMS Field Test Form and Instruction Modified
236589 PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction ModifiedPRAMS Opioid Call-back Survey (Spanish)
236589 PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction ModifiedPRAMS Opioid Call-back Survey (English)
236589 PRAMS Call-back Surveys (with Opioid Call-back Survey Example) Form and Instruction Modified
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Disabilities Supplement (web mode)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Disabilities Supplement (mail and phone)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Marijuana Use Supplement (web mode)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Marijuana Use Supplement (mail and phone)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Opioid Use Supplement (web mode)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Opioid Use Supplement (mail and phone)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS COVID-19 Experience Supplement (web mode)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS COVID-19 Experience Supplement (mail and phone)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS COVID-19 Vaccine Supplement (web mode)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS COVID-19 Vaccine Supplement (mail and phone)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Social Determinants of Health Supplement (web mode)
236588 PRAMS Supplemental Modules Form and Instruction ModifiedPRAMS Social Determinants of Health Supplement (mail and phone)
236588 PRAMS Supplemental Modules Form and Instruction Modified
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 9 Standard Web Module (Spanish)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 9 Standard Web Module (English)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 9 Standard Phone Questionnaire (Spanish)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 9 Standard Phone Questionnaire (English)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 9 Standard Mail Questionnaire (Spanish)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 9 Standard Mail Questionnaire (English)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 8 Standard Phone Module (Spanish)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 8 Standard Phone Module (English)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 8 Standard Mail Modules (Spanish)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 8 Standard Mail Modules (English)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 9 Core Web Questionnaire (Spanish)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 9 Core Web Questionnaire (English)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 9 Core Phone Questionnaire (Spanish)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 9 Core Phone Questionnaire (English)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 9 Core Mail Questionnaire (Spanish)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 9 Core Mail Questionnaire (English)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 8 Core Phone Questionnaire (English)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 8 Core Phone Questionnaire (English)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 8 Core Mail Questionnaire (Spanish)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Livebirth Phase 8 Core Mail Questionnaire (English)
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Phase 8 Web Survey - WY
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Phase 8 Web Survey - VA
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Phase 8 Web Survey - SC
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Phase 8 Web Survey - PR
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction ModifiedPRAMS Phase 8 Web Survey - MD
236587 PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2026 36 Months From Approved 03/31/2023
108,240 0 149,094
31,268 0 33,641
0 0 825,520





Reginfo record details
6
table that charts list of burden
IC Title Form No. Form Name
PRAMS Call-back Surveys (with Opioid Call-back Survey Example) n/a, n/a ,  
PRAMS Field Test None
PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules) None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None, None ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
PRAMS Stillbirth Survey None, None, None, None ,   ,   ,  
PRAMS Supplemental Modules None, None, None, None, None, None, None, None, None, None, None, None ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
Submission of Data File to CDC

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 108,240 149,094 0 -40,854 0 0
Annual Time Burden (Hours) 31,268 33,641 0 -2,373 0 0
Annual Cost Burden (Dollars) 0 825,520 0 -825,520 0 0


Reginfo record details
  No