[NCCDPHP] Pregnancy Risk Assessment Monitoring System (PRAMS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-1273 PRAMS Stillbirth Phone Questionnaire (Spanish)	Form and Instruction	Unchanged	Available
Form 0920-1273 PRAMS Stillbirth Phone Questionnaire (Spanish)	Form and Instruction	Unchanged	Available
Form 0920-1273 PRAMS Stillbirth Phone Questionnaire (English)	Form and Instruction	Unchanged	Available
Form 0920-1273 PRAMS Stillbirth Phone Questionnaire (English)	Form and Instruction	Unchanged	Available
Form 0920-1273 PRAMS Stillbirth Mail Questionnaire (Spanish)	Form and Instruction	Unchanged	Available
Form 0920-1273 PRAMS Stillbirth Mail Questionnaire (Spanish)	Form and Instruction	Unchanged	Available
Form 0920-1273 PRAMS Stillbirth Mail Questionnaire (English)	Form and Instruction	Unchanged	Available
Form 0920-1273 PRAMS Stillbirth Mail Questionnaire (English)	Form and Instruction	Unchanged	Available
PRAMS Disabilities Supplement (web mode)	Form and Instruction	Unchanged	Available
PRAMS Disabilities Supplement (web mode)	Form and Instruction	Unchanged	Available
PRAMS Disabilities Supplement (mail and phone)	Form and Instruction	Unchanged	Available
PRAMS Disabilities Supplement (mail and phone)	Form and Instruction	Unchanged	Available
PRAMS Marijuana Use Supplement (web mode)	Form and Instruction	Unchanged	Available
PRAMS Marijuana Use Supplement (web mode)	Form and Instruction	Unchanged	Available
PRAMS Marijuana Use Supplement (mail and phone)	Form and Instruction	Unchanged	Available
PRAMS Marijuana Use Supplement (mail and phone)	Form and Instruction	Unchanged	Available
PRAMS Opioid Use Supplement (web mode)	Form and Instruction	Unchanged	Available
PRAMS Opioid Use Supplement (web mode)	Form and Instruction	Unchanged	Available
PRAMS Opioid Use Supplement (mail and phone)	Form and Instruction	Unchanged	Available
PRAMS Opioid Use Supplement (mail and phone)	Form and Instruction	Unchanged	Available
PRAMS COVID-19 Experience Supplement (web mode)	Form and Instruction	Unchanged	Available
PRAMS COVID-19 Experience Supplement (web mode)	Form and Instruction	Unchanged	Available
PRAMS COVID-19 Experience Supplement (mail and phone)	Form and Instruction	Unchanged	Available
PRAMS COVID-19 Experience Supplement (mail and phone)	Form and Instruction	Unchanged	Available
PRAMS COVID-19 Vaccine Supplement (web mode)	Form and Instruction	Unchanged	Available
PRAMS COVID-19 Vaccine Supplement (web mode)	Form and Instruction	Unchanged	Available
PRAMS COVID-19 Vaccine Supplement (mail and phone)	Form and Instruction	Unchanged	Available
PRAMS COVID-19 Vaccine Supplement (mail and phone)	Form and Instruction	Unchanged	Available
PRAMS Social Determinants of Health Supplement (web mode)	Form and Instruction	Unchanged	Available
PRAMS Social Determinants of Health Supplement (web mode)	Form and Instruction	Unchanged	Available
PRAMS Social Determinants of Health Supplement (mail and phone)	Form and Instruction	Unchanged	Available
PRAMS Social Determinants of Health Supplement (mail and phone)	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Standard Web Module – Spanish	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Standard Web Module – Spanish	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Standard Web Module – English	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Standard Web Module – English	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Standard Phone Questionnaire – Spanish	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Standard Phone Questionnaire – Spanish	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Standard Phone Questionnaire – English	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Standard Phone Questionnaire – English	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Standard Mail Questionnaire – Spanish	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Standard Mail Questionnaire – Spanish	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Standard Mail Questionnaire – English	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Standard Mail Questionnaire – English	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Core Web Questionnaire – Spanish	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Core Web Questionnaire – Spanish	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Core Web Questionnaire – English	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Core Web Questionnaire – English	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Core Phone Questionnaire – Spanish	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Core Phone Questionnaire – Spanish	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Core Phone Questionnaire – English	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Core Phone Questionnaire – English	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Core Mail Questionnaire – Spanish	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Core Mail Questionnaire – Spanish	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Core Mail Questionnaire – English	Form and Instruction	Unchanged	Available
Form 0920-1273 Phase 9 Core Mail Questionnaire – English	Form and Instruction	Unchanged	Available
OMB_Change Request_PRAMS 8-16-26.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2026-09-10	Available
OMB_Change Request_PRAMS 8-16-26.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2026-09-10	Available
Att 5 - PRAMS Response Gifts and Incentives by Jurisdiction 8-16-26.docx	Supplementary Document	Uploaded 2026-09-10	Available
Att 5 - PRAMS Response Gifts and Incentives by Jurisdiction 8-16-26.docx	Supplementary Document	Uploaded 2026-09-10	Available
1273 PRAMS Supporting Statement B.docx	Supporting Statement B	Uploaded 2026-02-25	Available
1273 PRAMS Supporting Statement B.docx	Supporting Statement B	Uploaded 2026-02-25	Available
1273 PRAMS Supporting Statement A 19MAY2026_CLEAN.docx	Supporting Statement A	Uploaded 2026-05-20	Available
1273 PRAMS Supporting Statement A 19MAY2026_CLEAN.docx	Supporting Statement A	Uploaded 2026-05-20	Available
Att 4 - PRAMS Questionnaire Development Process.docx	Supplementary Document	Uploaded 2026-02-25	Available
Att 4 - PRAMS Questionnaire Development Process.docx	Supplementary Document	Uploaded 2026-02-25	Available
Att 3b_ Public Comments.docx	Supplementary Document	Uploaded 2026-02-25	Available
Att 3b_ Public Comments.docx	Supplementary Document	Uploaded 2026-02-25	Available
Att 3a -Published 60 day FRN.pdf	Supplementary Document	Uploaded 2026-02-25	Available
Att 3a -Published 60 day FRN.pdf	Supplementary Document	Uploaded 2026-02-25	Available
OMB_Change Request_0920_1273_PRAMS_04_10_25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-16	Available
OMB_Change Request_0920_1273_PRAMS_04_10_25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-16	Available
OMB_Change Request_PRAMS 11-13-24.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-11-21	Available
OMB_Change Request_PRAMS 11-13-24.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-11-21	Available
Att 17 - PRAMS Phase 9 Cognitive Testing Report.pdf	Supplementary Document	Uploaded 2023-05-25	Available
Att 17 - PRAMS Phase 9 Cognitive Testing Report.pdf	Supplementary Document	Uploaded 2023-05-25	Available
0920-1273 Response to Terms of Clearance _05_23_2023.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-05-25	Available
0920-1273 Response to Terms of Clearance _05_23_2023.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-05-25	Available
FINAL for signature - Stacey Y Brayboy_March of Dimes - CAPS 00264282_signed.docx	Supplementary Document	Uploaded 2023-05-25	Available
FINAL for signature - Stacey Y Brayboy_March of Dimes - CAPS 00264282_signed.docx	Supplementary Document	Uploaded 2023-05-25	Available
Attachment 19a. Nonresponse Bias Assessment of 2020 and 2021 Data.docx	Supplementary Document	Uploaded 2024-11-21	Available
Attachment 19a. Nonresponse Bias Assessment of 2020 and 2021 Data.docx	Supplementary Document	Uploaded 2024-11-21	Available
Att 18 - PRAMS Phase 9 Field Testing Report.pdf	Supplementary Document	Uploaded 2023-03-22	Available
Att 18 - PRAMS Phase 9 Field Testing Report.pdf	Supplementary Document	Uploaded 2023-03-22	Available
Att 2f - PRAMS Phase 8 Web Mode Data Collection Metrics_03132023.docx	Supplementary Document	Uploaded 2023-03-22	Available
Att 2f - PRAMS Phase 8 Web Mode Data Collection Metrics_03132023.docx	Supplementary Document	Uploaded 2023-03-22	Available
Att 16 Summary of Changes between Phase 8 and 9.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 16 Summary of Changes between Phase 8 and 9.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 15a - PRAMS Field Testing Methodology _03 13 2023 clean.docx	Supplementary Document	Uploaded 2023-03-22	Available
Att 15a - PRAMS Field Testing Methodology _03 13 2023 clean.docx	Supplementary Document	Uploaded 2023-03-22	Available
Att 14 - PRAMS Live Birth Sample Size by Jurisdiction.xlsx	Supplementary Document	Uploaded 2022-11-29	Available
Att 14 - PRAMS Live Birth Sample Size by Jurisdiction.xlsx	Supplementary Document	Uploaded 2022-11-29	Available
Att 13 - PRAMS IRB Approval_2022.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 13 - PRAMS IRB Approval_2022.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12j - Livebirth Web Introduction and Informed Consent - SPANISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12j - Livebirth Web Introduction and Informed Consent - SPANISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12i - PRAMS Livebirth Web Introduction and Informed Consent - ENGLISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12i - PRAMS Livebirth Web Introduction and Informed Consent - ENGLISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12h - Stillbirth Phone Introduction and Informed Consent_SPANISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12h - Stillbirth Phone Introduction and Informed Consent_SPANISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12g - Stillbirth Phone Introduction and Informed Consent_ENGLISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12g - Stillbirth Phone Introduction and Informed Consent_ENGLISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12f - PRAMS Livebirth Phone Introduction and Informed Consent - SPANISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12f - PRAMS Livebirth Phone Introduction and Informed Consent - SPANISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12e - PRAMS Livebirth Phone Introduction and Informed Consent - ENGLISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12e - PRAMS Livebirth Phone Introduction and Informed Consent - ENGLISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12d - Stillbirth Mail Introduction and Informed Consent - SPANISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12d - Stillbirth Mail Introduction and Informed Consent - SPANISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12c - Stillbirth Mail Introduction and Informed Consent_ENGLISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12c - Stillbirth Mail Introduction and Informed Consent_ENGLISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12b - PRAMS Livebirth Mail Introduction and Informed Consent - SPANISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12b - PRAMS Livebirth Mail Introduction and Informed Consent - SPANISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12a - PRAMS Livebirth Mail Introduction and Informed Consent - ENGLISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 12a - PRAMS Livebirth Mail Introduction and Informed Consent - ENGLISH.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 7 - PRAMS Livebirth Phase 8 and Phase 9 Questionnaire Topic Reference.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 7 - PRAMS Livebirth Phase 8 and Phase 9 Questionnaire Topic Reference.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 6 - PIDS Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2022-11-29	Available
Att 6 - PIDS Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2022-11-29	Available
Att 5 - PRAMS Response Gifts and Incentives by Jurisdiction 03 13 2023 clean.docx	Supplementary Document	Uploaded 2023-03-22	Available
Att 5 - PRAMS Response Gifts and Incentives by Jurisdiction 03 13 2023 clean.docx	Supplementary Document	Uploaded 2023-03-22	Available
Att 4 - PRAMS Questionnaire Development Process.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 4 - PRAMS Questionnaire Development Process.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 3b - Program Response to Comments 60 Day FRN.pdf	Supplementary Document	Uploaded 2022-11-29	Available
Att 3b - Program Response to Comments 60 Day FRN.pdf	Supplementary Document	Uploaded 2022-11-29	Available
Att 3a - Published 60 Day FRN.pdf	Supplementary Document	Uploaded 2022-11-29	Available
Att 3a - Published 60 Day FRN.pdf	Supplementary Document	Uploaded 2022-11-29	Available
Att 1c PREEMIE Reauthorization Act of 2018.pdf	Supplementary Document	Uploaded 2022-11-29	Available
Att 1c PREEMIE Reauthorization Act of 2018.pdf	Supplementary Document	Uploaded 2022-11-29	Available
Att 1b Safe Motherhood and Infant Health Authorization.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 1b Safe Motherhood and Infant Health Authorization.docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 1a-Section 301 of the Public Health Service Act (42 U.S.C. 241).docx	Supplementary Document	Uploaded 2022-11-29	Available
Att 1a-Section 301 of the Public Health Service Act (42 U.S.C. 241).docx	Supplementary Document	Uploaded 2022-11-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
257195	Submission of Data File to CDC	Instruction	Unchanged
236591	PRAMS Stillbirth Questionnaire	Form and Instruction	Unchanged	PRAMS Stillbirth Phone Questionnaire (Spanish)
236591	PRAMS Stillbirth Questionnaire	Form and Instruction	Unchanged	PRAMS Stillbirth Phone Questionnaire (Spanish)
236591	PRAMS Stillbirth Questionnaire	Form and Instruction	Unchanged	PRAMS Stillbirth Phone Questionnaire (English)
236591	PRAMS Stillbirth Questionnaire	Form and Instruction	Unchanged	PRAMS Stillbirth Phone Questionnaire (English)
236591	PRAMS Stillbirth Questionnaire	Form and Instruction	Unchanged	PRAMS Stillbirth Mail Questionnaire (Spanish)
236591	PRAMS Stillbirth Questionnaire	Form and Instruction	Unchanged	PRAMS Stillbirth Mail Questionnaire (Spanish)
236591	PRAMS Stillbirth Questionnaire	Form and Instruction	Unchanged	PRAMS Stillbirth Mail Questionnaire (English)
236591	PRAMS Stillbirth Questionnaire	Form and Instruction	Unchanged	PRAMS Stillbirth Mail Questionnaire (English)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Disabilities Supplement (web mode)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Disabilities Supplement (web mode)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Disabilities Supplement (mail and phone)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Disabilities Supplement (mail and phone)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Marijuana Use Supplement (web mode)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Marijuana Use Supplement (web mode)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Marijuana Use Supplement (mail and phone)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Marijuana Use Supplement (mail and phone)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Opioid Use Supplement (web mode)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Opioid Use Supplement (web mode)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Opioid Use Supplement (mail and phone)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Opioid Use Supplement (mail and phone)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS COVID-19 Experience Supplement (web mode)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS COVID-19 Experience Supplement (web mode)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS COVID-19 Experience Supplement (mail and phone)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS COVID-19 Experience Supplement (mail and phone)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS COVID-19 Vaccine Supplement (web mode)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS COVID-19 Vaccine Supplement (web mode)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS COVID-19 Vaccine Supplement (mail and phone)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS COVID-19 Vaccine Supplement (mail and phone)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Social Determinants of Health Supplement (web mode)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Social Determinants of Health Supplement (web mode)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Social Determinants of Health Supplement (mail and phone)
236588	PRAMS Supplemental Modules	Form and Instruction	Unchanged	PRAMS Social Determinants of Health Supplement (mail and phone)
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Standard Web Module – Spanish
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Standard Web Module – Spanish
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Standard Web Module – English
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Standard Web Module – English
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Standard Phone Questionnaire – Spanish
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Standard Phone Questionnaire – Spanish
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Standard Phone Questionnaire – English
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Standard Phone Questionnaire – English
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Standard Mail Questionnaire – Spanish
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Standard Mail Questionnaire – Spanish
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Standard Mail Questionnaire – English
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Standard Mail Questionnaire – English
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Core Web Questionnaire – Spanish
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Core Web Questionnaire – Spanish
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Core Web Questionnaire – English
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Core Web Questionnaire – English
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Core Phone Questionnaire – Spanish
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Core Phone Questionnaire – Spanish
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Core Phone Questionnaire – English
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Core Phone Questionnaire – English
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Core Mail Questionnaire – Spanish
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Core Mail Questionnaire – Spanish
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Core Mail Questionnaire – English
236587	PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	Form and Instruction	Unchanged	Phase 9 Core Mail Questionnaire – English

ICR Details

OMB Control No: 0920-1273	ICR Reference No: 202609-0920-002
Status: Historical Inactive	Previous ICR Reference No: 202602-0920-010
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-26-0274
Title: [NCCDPHP] Pregnancy Risk Assessment Monitoring System (PRAMS)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Disapproved and continue	Conclusion Date: 09/14/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/10/2026
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2029	05/31/2029	05/31/2029
Responses	105,300	0	105,300
Time Burden (Hours)	29,773	0	29,773
Cost Burden (Dollars)	0	0	0

---

Abstract: Pregnancy Risk Assessment Monitoring System (PRAMS) is designed to collect jurisdiction-specific (states, cities, and U.S territories), population-based data on maternal behaviors and experiences before, during, and shortly after pregnancy. PRAMS is a jurisdiction customized survey conducted in 50 jurisdictions in the United States (U.S.). The data are used to identify groups of women and infants at high risk for health problems, monitor changes in health status, and measure progress towards state and national objectives in improving the health of mothers and infants. This Revision is submitted to request approval for an additional three years. Some components of the data collection have been completed (i.e., call back surveys, cognitive and field testing) resulting in reduced burden hours. Specifically, removal of call back surveys decreased annual burden by 1,395 hours and removal of cognitive and field testing decreased annual burden by 100 hours.

---

Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act: Research and Investigations
   PL: Pub.L. 109 - 450 3 Name of Law: PREEMIE Act
   US Code: 42 USC 247b-12 Name of Law: Safe Motherhood and Infant Health
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 52666	11/21/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 11314	03/09/2026
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)	0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273, 0920-1273	Phase 9 Core Mail Questionnaire – English ,   Phase 9 Core Mail Questionnaire – Spanish ,   Phase 9 Core Phone Questionnaire – English ,   Phase 9 Core Phone Questionnaire – Spanish ,   Phase 9 Core Web Questionnaire – English ,   Phase 9 Core Web Questionnaire – Spanish ,   Phase 9 Standard Mail Questionnaire – English ,   Phase 9 Standard Mail Questionnaire – Spanish ,   Phase 9 Standard Phone Questionnaire – English ,   Phase 9 Standard Phone Questionnaire – Spanish ,   Phase 9 Standard Web Module – English ,   Phase 9 Standard Web Module – Spanish
PRAMS Stillbirth Questionnaire	0920-1273, 0920-1273, 0920-1273, 0920-1273	PRAMS Stillbirth Mail Questionnaire (English) ,   PRAMS Stillbirth Mail Questionnaire (Spanish) ,   PRAMS Stillbirth Phone Questionnaire (English) ,   PRAMS Stillbirth Phone Questionnaire (Spanish)
PRAMS Supplemental Modules	None, None, None, None, None, None, None, None, None, None, None, None	PRAMS Social Determinants of Health Supplement (mail and phone) ,   PRAMS Social Determinants of Health Supplement (web mode) ,   PRAMS COVID-19 Vaccine Supplement (mail and phone) ,   PRAMS COVID-19 Vaccine Supplement (web mode) ,   PRAMS COVID-19 Experience Supplement (mail and phone) ,   PRAMS COVID-19 Experience Supplement (web mode) ,   PRAMS Opioid Use Supplement (mail and phone) ,   PRAMS Opioid Use Supplement (web mode) ,   PRAMS Marijuana Use Supplement (mail and phone) ,   PRAMS Marijuana Use Supplement (web mode) ,   PRAMS Disabilities Supplement (mail and phone) ,   PRAMS Disabilities Supplement (web mode)
Submission of Data File to CDC

---

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Revision package for 0920-1273 is submitted to request approval for an additional three years. Some components of the data collection have been completed (i.e., call back surveys, cognitive and field testing) resulting in reduced burden hours. Specifically, removal of call back surveys decreased annual burden by 1,395 hours and removal of cognitive and field testing decreased annual burden by 100 hours. Total burden is decreased to 29,773 annual burden hours.

---

Annual Cost to Federal Government: $13,714,785

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/10/2026

---