Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Consent for Bloodspot Retrieval Modified 1850 463 0 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 Modified 2590 648 0 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 0 Form and Instruction n/a Core CATI
Form and Instruction n/a Core CATI (Spanish)
Occupational Questionnaires Modified 830 277 0 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
Stillbirth COVID-19 Sub-Study New 157 40 0 Form and Instruction n/a Stillbirth COVID-19 Sub-Study Form (Interviewed)
Form and Instruction n/a Stillbirth COVID-19 Sub-Study Form (Non-Interviewed)
Form and Instruction n/a Stillbirth COVID-19 Sub-Study Form (Interviewed) Spanish
Form and Instruction n/a Stillbirth COVID-19 Sub-Study Form (Non-Interviewed) Spanish
Supplemental CATI about Stillbirth Modified 640 267 0 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: 9097 4473 0  
To view an IC, click on IC Title