US Zika Pregnancy Registry

OMB 0920-1143

Latest Forms, Documents, and Supporting Material

Document Name
Infant Health Follow-Up Form Form and Instruction
Neonate Assessment at Delivery Form Form and Instruction
Laboratory Results Form Form and Instruction
Supplemental Maternal Prenatal Imaging and Diagnostics Form Form and Instruction
Maternal Health History Form Form and Instruction
ATT_2_Updated_NRD_Email.pdf Supplementary Document
0920-1143 Non-sub Change Request_10242017.docx Justification for No Material/Nonsubstantive Change
Change Request_Provider Letters and Fact Sheets.docx Justification for No Material/Nonsubstantive Change
Att 7c Fact Sheet for Health Departments.pdf Supplementary Document
Att 7b Fact Sheet for Pediatric Provider.pdf Supplementary Document
Att 7a Fact Sheet for Obstetic Provider.pdf Supplementary Document
Att 6b Provider Overview Letter - Pedatric Provider.pdf Supplementary Document
Att 6a Provider Overview Letter - Obstetric Provider.pdf Supplementary Document
Att 5b Fact Sheet for Parents.pdf Supplementary Document
Att 5a Fact Sheet for Pregnant Women.pdf Supplementary Document
SSB - Zika Pregnancy Registry_03NOV2016.docx Supporting Statement B
SSA - Zika Pregnancy Registry_03NOV2016.docx Supporting Statement A
Att 11 USZPR ICR Nonresearch Determination.pdf Supplementary Document
Att 10 USZPR ICR Assurance of Confidentialty.pdf Supplementary Document
Att 9b USZPR ICR Developmental Milestones for Infant.docx Supplementary Document
Att. 2b -- Public Comment.pdf Supplementary Document
Att. 2a -- 60-day FRN.pdf Supplementary Document
Att 3 USZPR ICR_CSTE Interim Case Definition 2_26_16.pdf Supplementary Document
Att 1 USZPR ICR_Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document
Infant Health Follow-Up Form Form and Instruction
Neonate Assessment at Delivery Form Form and Instruction
Laboratory Results Form Form and Instruction
Supplemental Maternal Prenatal Imaging and Diagnostics Form Form and Instruction
Maternal Health History Form Form and Instruction

All Historical Document Collections

201710-0920-014 Approved without change	No material or nonsubstantive change to a currently approved collection	2017-10-31
201703-0920-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2017-03-03
201607-0920-002 Approved with change	New collection (Request for a new OMB Control Number)	2016-07-28