Supplemental CATI about Stillbirth

[NCBDDD] Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS)

Documents and Forms

Document Name Document Type
Supplemental CATI about Stillbirth Form and Instruction
Supplemental CATI about Stillbirth Form and Instruction
Computer Assisted Phone Interview about Stillbirth (Engl AttG1a_Supplemental_CATI.docx Form and Instruction
Computer Assisted Phone Interview about Stillbirth (Engl AttG1a_Supplemental_CATI.docx Form and Instruction
Computer Assisted Phone Interview about Stillbirth (Span AttG1b_Supplemental_CATI.docx Form and Instruction
Computer Assisted Phone Interview about Stillbirth (Span AttG1b_Supplemental_CATI.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Supplemental CATI about Stillbirth	Agency IC Tracking Number:	0920-0010

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Computer Assisted Phone Interview about Stillbirth (English)	AttG1a_Supplemental_CATI.docx		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Computer Assisted Phone Interview about Stillbirth (Spanish)	AttG1b_Supplemental_CATI.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 640	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	640	640
Annual IC Time Burden (Hours)	267	267
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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