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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
PRAMS Phase 8 and Phase 9 Questionnaires (Core Questions plus State-selected Standard Modules)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
None
PRAMS Phase 8 Web Survey - MD
Att 2a - PRAMS Phase 8 Web Survey - MD.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
None
PRAMS Phase 8 Web Survey - PR
Att 2b - PRAMS Phase 8 Web Survey - PR.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
None
PRAMS Phase 8 Web Survey - SC
Att 2c - PRAMS Phase 8 Web Survey - SC.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
None
PRAMS Phase 8 Web Survey - VA
Att 2d - PRAMS Phase 8 Web Survey - VA.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
None
PRAMS Phase 8 Web Survey - WY
Att 2e - PRAMS Phase 8 Web Survey - WY.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
None
PRAMS Livebirth Phase 8 Core Mail Questionnaire (English)
Att 8a - PRAMS Livebirth Phase 8 Core Mail Questionnaire_ENGLISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 8 Core Mail Questionnaire (Spanish)
Att 8b - PRAMS Livebirth Phase 8 Core Mail Questionnaire_SPANISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 8 Core Phone Questionnaire (English)
Att 8c - PRAMS Livebirth Phase 8 Core Phone Questionnaire_ENGLISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 8 Core Phone Questionnaire (English)
Att 8d - PRAMS Livebirth Phase 8 Core Phone Questionnaire_SPANISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 9 Core Mail Questionnaire (English)
Att 8e - PRAMS Livebirth Phase 9 Core Mail Questionnaire - ENGLISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 9 Core Mail Questionnaire (Spanish)
Att 8f - PRAMS Livebirth Phase 9 Core Mail Questionnaire_SPANISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 9 Core Phone Questionnaire (English)
Att 8g - PRAMS Livebirth Phase 9 Core Phone Questionnaire - ENGLISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 9 Core Phone Questionnaire (Spanish)
Att 8h - PRAMS Livebirth Phase 9 Core Phone Questionnaire - SPANISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 9 Core Web Questionnaire (English)
Att 8i - PRAMS Livebirth Phase 9 Core Web Questionnaire - ENGLISH.docx
Yes
Yes
Fillable Fileable
Form and Instruction
None
PRAMS Livebirth Phase 9 Core Web Questionnaire (Spanish)
Att 8j - PRAMS Livebirth Phase 9 Core Web Questionniare - SPANISH.docx
Yes
Yes
Fillable Fileable
Form and Instruction
None
PRAMS Livebirth Phase 8 Standard Mail Modules (English)
Att 10a - PRAMS Livebirth Phase 8 Standard Mail Module_ENGLISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 8 Standard Mail Modules (Spanish)
Att 10b - PRAMS Livebirth Phase 8 Standard Mail Module_SPANISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 8 Standard Phone Module (English)
Att 10c - PRAMS Livebirth Phase 8 Standard Phone Module_ENGLISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 8 Standard Phone Module (Spanish)
Att 10d - PRAMS Livebirth Phase 8 Standard Phone Module_SPANISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 9 Standard Mail Questionnaire (English)
Att 10e - PRAMS Livebirth Phase 9 Standard Mail Questionnaire - ENGLISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 9 Standard Mail Questionnaire (Spanish)
Att 10f - PRAMS Livebirth Phase 9 Standard Mail Questionnaire_SPANISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 9 Standard Phone Questionnaire (English)
Att 10g - PRAMS Livebirth Phase 9 Standard Phone Questionnaire_ENGLISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 9 Standard Phone Questionnaire (Spanish)
Att 10h - PRAMS Livebirth Phase 9 Standard Phone Questionnaire_SPANISH.docx
No
Paper Only
Form and Instruction
None
PRAMS Livebirth Phase 9 Standard Web Module (English)
Att 10i - PRAMS Livebirth Phase 9 Standard Web Module - ENGLISH.docx
Yes
Yes
Fillable Fileable
Form and Instruction
None
PRAMS Livebirth Phase 9 Standard Web Module (Spanish)
Att 10j - PRAMS Livebirth Phase 9 Standard Web Module - SPANISH.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0160 Records of Subjects in Health Promotion and Education Studies
FR Citation:
51 FR 42484
Number of Respondents:
51,556
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
34 %
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
51,556
0
0
0
0
51,556
Annual IC Time Burden (Hours)
22,341
0
0
0
0
22,341
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.