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

View Information Collection (IC)

Fertility Knowledge Survey
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 No   Printable Only

Health Public Health Monitoring

 

4,000 0
   
Individuals or Households
 
   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 4,000 0 4,000 0 0 0
Annual IC Time Burden (Hours) 1,333 0 1,333 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment A Title X Legislation 10/03/2019
Attachment C OMB FRN 60 and 30 day 10/03/2019
Attachment D IRB Approval 10/03/2019
Attachment E Email Invitation 10/03/2019
Attachment F Consent Form 10/03/2019
Attachment G Email Reminder 10/03/2019
Attachment H Bill of Rights 10/03/2019
Attachment I Member Privacy Policy 10/03/2019
Attachment J Ipsos Privacy Commitment 10/03/2019
Attachment K CoC 10/03/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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