PRAMS Stillbirth Survey

Pregnancy Risk Assessment Monitoring System (PRAMS)

OMB: 0920-1273

IC ID: 236591

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
Information Collection (IC) Details

View Information Collection (IC)

PRAMS Stillbirth Survey
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None PRAMS Stillbirth Mail Questionnaire (English) Att 9a - PRAMS UT Stillbirth Questionnaire Mail_ENGLISH.pdf No   Paper Only
Form and Instruction None PRAMS Stillbirth Mail Questionnaire (Spanish) Att 9b - PRAMS UT Stillbirth Questionnaire Mail_SPANISH.pdf No   Paper Only
Form and Instruction None PRAMS Stillbirth Phone Questionnaire (English) Att 9c - PRAMS UT Stillbirth Phone Questionnaire_ENGLISH.docx No   Paper Only
Form and Instruction None PRAMS Stillbirth Phone Questionnaire (Spanish) Att 9d - PRAMS UT Stillbirth Phone Questionnaire_SPANISH.docx No   Paper Only

Health Public Health Monitoring

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

160 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 160 0 0 0 0 160
Annual IC Time Burden (Hours) 67 0 0 0 0 67
Annual IC Cost Burden (Dollars) 0 0 -1,636 0 0 1,636

Title Document Date Uploaded
PRAMS Stillbirth Mail Introduction and Informed Consent (English) Att 12c - Stillbirth Mail Introduction and Informed Consent_ENGLISH.docx 11/29/2022
PRAMS Stillbirth Mail Introduction and Informed Consent (Spanish) Att 12d - Stillbirth Mail Introduction and Informed Consent - SPANISH.docx 11/29/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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