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Federal forms, ICRs, and supporting documents

Information Collection

PRAMS Stillbirth Questionnaire

IC 236591 under ICR 202602-0920-010 · OMB 0920-1273.

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
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

PRAMS Stillbirth Questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1273 PRAMS Stillbirth Mail Questionnaire (English) Att 9a - PRAMS Stillbirth Questionnaire Mail_ENGLISH.pdf N/A No   Fillable Fileable
Form and Instruction 0920-1273 PRAMS Stillbirth Mail Questionnaire (Spanish) Att 9b - PRAMS Stillbirth Questionnaire Mail_SPANISH.pdf N/A No   Fillable Fileable
Form and Instruction 0920-1273 PRAMS Stillbirth Phone Questionnaire (English) Att 9c - PRAMS Stillbirth Phone Questionnaire_ENGLISH.docx N/A Yes Yes Fillable Fileable
Form and Instruction 0920-1273 PRAMS Stillbirth Phone Questionnaire (Spanish) Att 9d - PRAMS Stillbirth Phone Questionnaire_SPANISH.docx N/A Yes Yes Fillable Fileable

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 %

  Requested 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 0 0 0 0

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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