Information Collection

PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)

IC 236587 under ICR 202602-0920-010 · OMB 0920-1273.

Documents and Forms

Document Name Document Type
Form 0920-1273 Phase 9 Core Mail Questionnaire – English PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
Form 0920-1273 Phase 9 Core Mail Questionnaire – Spanish PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
Form 0920-1273 Phase 9 Core Phone Questionnaire – English PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
Form 0920-1273 Phase 9 Core Phone Questionnaire – Spanish PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
Form 0920-1273 Phase 9 Core Web Questionnaire – English PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
Form 0920-1273 Phase 9 Core Web Questionnaire – Spanish PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
Form 0920-1273 Phase 9 Standard Mail Questionnaire – English PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
Form 0920-1273 Phase 9 Standard Mail Questionnaire – Spanish PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
Form 0920-1273 Phase 9 Standard Phone Questionnaire – English PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
Form 0920-1273 Phase 9 Standard Phone Questionnaire – Spanish PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
Form 0920-1273 Phase 9 Standard Web Module – English PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
Form 0920-1273 Phase 9 Standard Web Module – Spanish PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules) Form and Instruction
0920-1273 Phase 9 Core Mail Questionnaire – English Att 8e - PRAMS Livebirth Phase 9 Core Mail Questionnaire_ENGLISH.docx Form and Instruction
0920-1273 Phase 9 Core Mail Questionnaire – Spanish Att 8f - PRAMS Livebirth Phase 9 Core Mail Questionnaire_SPANISH.docx Form and Instruction
0920-1273 Phase 9 Core Phone Questionnaire – English Att 8g - PRAMS Livebirth Phase 9 Core Phone Questionnaire_ENGLISH.pdf Form and Instruction
0920-1273 Phase 9 Core Phone Questionnaire – Spanish Att 8h - PRAMS Livebirth Phase 9 Core Phone Questionnaire_SPANISH.docx Form and Instruction
0920-1273 Phase 9 Core Web Questionnaire – English Att 8i - PRAMS Livebirth Phase 9 Core Web Questionnaire_ENGLISH.docx Form and Instruction
0920-1273 Phase 9 Core Web Questionnaire – Spanish Att 8j - PRAMS Livebirth Phase 9 Core Web Questionniare_SPANISH.docx Form and Instruction
0920-1273 Phase 9 Standard Mail Questionnaire – English Att 10e - PRAMS Livebirth Phase 9 Standard Mail Questionnaire_ENGLISH.docx Form and Instruction
0920-1273 Phase 9 Standard Mail Questionnaire – Spanish Att 10f - PRAMS Livebirth Phase 9 Standard Mail Questionnaire_SPANISH.docx Form and Instruction
0920-1273 Phase 9 Standard Phone Questionnaire – English Att 10g - PRAMS Livebirth Phase 9 Standard Phone Questionnaire_ENGLISH.pdf Form and Instruction
0920-1273 Phase 9 Standard Phone Questionnaire – Spanish Att 10h - PRAMS Livebirth Phase 9 Standard Phone Questionnaire_SPANISH.pdf Form and Instruction
0920-1273 Phase 9 Standard Web Module – English Att 10i - PRAMS Livebirth Phase 9 Standard Web Module_ENGLISH.docx Form and Instruction
0920-1273 Phase 9 Standard Web Module – Spanish Att 10j - PRAMS Livebirth Phase 9 Standard Web Module_SPANISH.docx Form and Instruction
1273 PRAMS SSA 04_10_25_clean.docx SSA IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	0920-1273	Phase 9 Core Mail Questionnaire â English	Att 8e - PRAMS Livebirth Phase 9 Core Mail Questionnaire_ENGLISH.docx	NA	No		Fillable Fileable
Form and Instruction	0920-1273	Phase 9 Core Mail Questionnaire â Spanish	Att 8f - PRAMS Livebirth Phase 9 Core Mail Questionnaire_SPANISH.docx	NA	No		Fillable Fileable
Form and Instruction	0920-1273	Phase 9 Core Phone Questionnaire â English	Att 8g - PRAMS Livebirth Phase 9 Core Phone Questionnaire_ENGLISH.pdf	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1273	Phase 9 Core Phone Questionnaire â Spanish	Att 8h - PRAMS Livebirth Phase 9 Core Phone Questionnaire_SPANISH.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1273	Phase 9 Core Web Questionnaire â English	Att 8i - PRAMS Livebirth Phase 9 Core Web Questionnaire_ENGLISH.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1273	Phase 9 Core Web Questionnaire â Spanish	Att 8j - PRAMS Livebirth Phase 9 Core Web Questionniare_SPANISH.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1273	Phase 9 Standard Mail Questionnaire â English	Att 10e - PRAMS Livebirth Phase 9 Standard Mail Questionnaire_ENGLISH.docx	NA	No		Fillable Fileable
Form and Instruction	0920-1273	Phase 9 Standard Mail Questionnaire â Spanish	Att 10f - PRAMS Livebirth Phase 9 Standard Mail Questionnaire_SPANISH.docx	NA	No		Fillable Fileable
Form and Instruction	0920-1273	Phase 9 Standard Phone Questionnaire â English	Att 10g - PRAMS Livebirth Phase 9 Standard Phone Questionnaire_ENGLISH.pdf	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1273	Phase 9 Standard Phone Questionnaire â Spanish	Att 10h - PRAMS Livebirth Phase 9 Standard Phone Questionnaire_SPANISH.pdf	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1273	Phase 9 Standard Web Module â English	Att 10i - PRAMS Livebirth Phase 9 Standard Web Module_ENGLISH.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1273	Phase 9 Standard Web Module â Spanish	Att 10j - PRAMS Livebirth Phase 9 Standard Web Module_SPANISH.docx	NA	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0160 Records of Subjects in Health Promotion and Education Studies	FR Citation: 51 FR 42484

Number of Respondents: 51,556	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 34 %

	Requested	Previously Approved
Annual Number of Responses for this IC	51,556	51,556
Annual IC Time Burden (Hours)	22,341	22,341
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA	1273 PRAMS SSA 04_10_25_clean.docx	04/16/2025

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

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