Information Collection Request
[NCBDDD] Population-based Surveillance of Outcomes, Needs, and Well-being of Children and Adolescents with Congenital Heart Defects
ICR 202305-0920-011 · OMB 0920-1382 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-1382 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Congenital Heart Survey To Recognize Outcomes, Needs, and wellbeinG of KIDS |
Form and Instruction | Modified | Available |
| Congenital Heart Survey To Recognize Outcomes, Needs, and wellbeinG of KIDS |
Form and Instruction | Modified | Repair queued |
 Att 35_MA Participant Info Sheet_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Available |
| Att 35_MA Participant Info Sheet_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 34_MA Intro_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Available |
| Att 34_MA Intro_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 33_MA Initial Letter_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Available |
| Att 33_MA Initial Letter_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 31_Opt-out postcard_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Available |
| Att 31_Opt-out postcard_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 30_Somali Intro_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Available |
| Att 30_Somali Intro_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 29_Somali Participant Info Sheet_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Available |
| Att 29_Somali Participant Info Sheet_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 26_ThankYouLetter Somali_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Available |
| Att 26_ThankYouLetter Somali_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| ICR Change request memo.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2023-05-25 | Available |
| ICR Change request memo.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2023-05-25 | Repair queued |
| Att 22_References_updated_clean.docx |
Supplementary Document | Uploaded 2022-11-23 | Available |
| Att 22_References_updated_clean.docx |
Supplementary Document | Uploaded 2022-11-23 | Repair queued |
| Att 21_Postcards_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Available |
| Att 21_Postcards_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 20_Initial Letter_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 20_Initial Letter_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
 Att 19_ Survey Question Crosswalk.xlsx |
Supplementary Document | Uploaded 2022-07-21 | Available |
| Att 19_ Survey Question Crosswalk.xlsx |
Supplementary Document | Uploaded 2022-07-21 | Repair queued |
| Att 18_Spanish Intro_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 18_Spanish Intro_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 17_English Intro_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Available |
| Att 17_English Intro_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 16_Spanish Participant Info Sheet.docx |
Supplementary Document | Uploaded 2022-07-21 | Available |
| Att 16_Spanish Participant Info Sheet.docx |
Supplementary Document | Uploaded 2022-07-21 | Repair queued |
| Att 15_English Participant Info Sheet_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Available |
| Att 15_English Participant Info Sheet_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
 Att 14_PIA_May23.pdf |
Supplementary Document | Uploaded 2023-05-25 | Available |
| Att 14_PIA_May23.pdf |
Supplementary Document | Uploaded 2023-05-25 | Available |
| Att 13_Research Determination.pdf |
Supplementary Document | Uploaded 2022-07-21 | Available |
| Att 13_Research Determination.pdf |
Supplementary Document | Uploaded 2022-07-21 | Repair queued |
| Att 12_ThankYouLetter Spanish.docx |
Supplementary Document | Uploaded 2022-07-21 | Available |
| Att 12_ThankYouLetter Spanish.docx |
Supplementary Document | Uploaded 2022-07-21 | Repair queued |
| Att 11_ThankYouLetter English.docx |
Supplementary Document | Uploaded 2022-07-21 | Available |
| Att 11_ThankYouLetter English.docx |
Supplementary Document | Uploaded 2022-07-21 | Repair queued |
| Att 3_List of Sites_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 3_List of Sites_May23.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att 2_60 Day OMB.pdf |
Supplementary Document | Uploaded 2022-07-21 | Available |
| Att 2_60 Day OMB.pdf |
Supplementary Document | Uploaded 2022-07-21 | Repair queued |
| Att 1_Auth Legislation.pdf |
Supplementary Document | Uploaded 2022-07-21 | Available |
| Att 1_Auth Legislation.pdf |
Supplementary Document | Uploaded 2022-07-21 | Repair queued |
| SupportingStatementPartB full_clean.docx |
Supporting Statement B | Uploaded 2022-11-23 | Available |
| SupportingStatementPartB full_clean.docx |
Supporting Statement B | Uploaded 2022-11-23 | Repair queued |
| SSA_07132022_updated_clean.docx |
Supporting Statement A | Uploaded 2022-11-23 | Available |
| SSA_07132022_updated_clean.docx |
Supporting Statement A | Uploaded 2022-11-23 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 254790 |  Congenital Heart Survey To Recognize Outcomes, Needs, and wellbeinG of KIDS |
Form and Instruction | Modified | |
| 254790 | Congenital Heart Survey To Recognize Outcomes, Needs, and wellbeinG of KIDS |
Form and Instruction | Modified |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-1382 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202206-0920-002 |
| Agency Tracking No | 0920-23FH |
| Date Submitted to OIRA | 2023-05-26 |
| Requested Expiration Date | 1969-12-31 |