OMB control number
Emergency Zika Package IV: Assessment of Contraceptive Use and Needs, Puerto Rico, 2016
OMB 0920-1114 ยท HHS/CDC.
OMB 0920-1114
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Contraceptive Assessment Questionnaire | Form and Instruction |
| Contraceptive Assessment Screen | Form and Instruction |
| 0920-1114 Non-sub Change Request.docx | Justification for No Material/Nonsubstantive Change |
| SSB - Emergency Zika IV clean OMB 18MAY2016.docx | Supporting Statement B |
| SSA - Emergency Zika IV clean.docx | Supporting Statement A |
 Att. D - IRB Determination.PDF | Supplementary Document |
| Emergency Request Memo_Zika IV_signed 5 16 2016.pdf | Supplementary Document |
| Att. A - Section 301 of the Public Health Service Act (42 USC 241).pdf | Supplementary Document |
 Contraceptive Assessment Questionnaire |
Form and Instruction |
| Contraceptive Assessment Screen |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201606-0920-020 | No material or nonsubstantive change to a currently approved collection | 2016-06-29 | Approved without change | |
| 201605-0920-008 | New collection (Request for a new OMB Control Number) | 2016-05-18 | Approved without change |