View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Birth Certificate and Hospital Discharge Linkage - State Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Birth Certificate and Hospital Discharge Survey - AMCHP Attachment C_AMCHP Screenshots_8 14 2012.doc Yes Yes Fillable Fileable
Form none Birth Certificate and Hospital Discharge - NAPHSIS Attachment B_NAPHSIS Screenshots_8 14 2012.docx Yes Yes Fillable Fileable

Health Immunization Management

 

104 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 104 0 0 0 0 0
Annual IC Time Burden (Hours) 43 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A DRH_Supporting Statement A_8 24 2012.docx 08/27/2012
Supporting Statement B DRH_Supporting Statement B_8 24 2012.docx 08/27/2012
Birth Certificate and Hospital Discharge - Word version Attachment A_Survey Questions_8_14 2012.docx 08/27/2012
Att D - Advance Emails Attachment D_Advance Survey Notification Email_8 14 2012.docx 08/27/2012
Att E - Notification Emails Attachment E_Survey Notification Email_8 14 2012.docx 08/27/2012
Att F - Reminders Attachment F_Reminders (Email and Telephone)_8 24 2012.docx 08/27/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.