Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Consent for Bloodspot Retrieval Unchanged 1850 463 4625 Form and Instruction n/a Bloodspot Consent (English)
Form and Instruction n/a Bloodspot Verbal Consent (English)
Form and Instruction n/a Bloodspot Consent for Multiples (English)
Form and Instruction n/a Bloodspot Verbal Consent for Multiples (English)
Form and Instruction n/a Bloodspot Consent (Spanish)
Form and Instruction n/a Bloodspot Verbal Consent (Spanish)
Form and Instruction n/a Bloodspot Consent for Multiples (Spanish)
Form and Instruction n/a Bloodspot Verbal Consent for Multiples (Spanish)
Consent for Linkage to Reportable Infectious Diseases Results Unchanged 2590 648 6475 Form and Instruction n/a Written Consent for Release of Reportable Infectious Diseases (English)
Form and Instruction n/a Written Consent for Release of Reportable Infectious Diseases (Spanish)
Form and Instruction n/a Verbal Consent for Release of Reportable Infectious Diseases (English)
Form and Instruction n/a Verbal Consent for Release of Reportable Infectious Diseases (Spanish)
Mother's Consent Script and Computer Assisted Telephone Interview Modified 3030 2778 27776 Form and Instruction n/a Introductory Phone Script (English)
Form and Instruction n/a Introductory Phone Script (Spansih)
Form and Instruction 0920-0010 BDSTEPS_CATI_V9.0
Form and Instruction 0920-0010 BDSTEPS_CATI_V9.0_SPAN
Occupational Questionnaires Unchanged 830 277 2764 Form and Instruction n/a Agriculture_Screenshots_English
Form and Instruction n/a Agriculture_Screenshots_Spanish
Form and Instruction n/a Cosmetology_Screenshots_English
Form and Instruction n/a Cosmetology_Screenshots_Spanish
Form and Instruction n/a Electronic Equipment Operators_Screenshots_English
Form and Instruction n/a Electronic Equipment Operators_Screenshots_Spanish
Form and Instruction n/a Healthcare_Screenshots_English
Form and Instruction n/a Healthcare_Screenshots_Spansih
Form and Instruction n/a Janitorial_Screenshots_English
Form and Instruction n/a Janitorial_Screenshots_Spanish
Form and Instruction n/a Office Worker_Screenshots_English
Form and Instruction n/a Office Worker_Screenshots_Spanish
Form and Instruction n/a Restaurant Worker_Screenshots_English
Form and Instruction n/a Restaurant Worker_Screenshots_Spanish
Form and Instruction n/a Teaching_Screenshots_English
Form and Instruction n/a Teaching_Screenshots_Spanish
Supplemental CATI about Stillbirth Unchanged 640 267 2667 Form and Instruction n/a Introductory Phone Script for the Interview about Stillborth (English)
Form and Instruction n/a Introductory Phone Script for the Interview about Stillborth (Spanish)
Form and Instruction n/a Computer Assisted Phone Interview about Stillbirth (English)
Form and Instruction n/a Computer Assisted Phone Interview about Stillbirth (Spanish)
Total burden requested under this ICR: 8940 4433 44307  
To view an IC, click on IC Title