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Agenda
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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
PRAMS Phase 9 Questionnaires (Core Questions plus Jurisdiction-selected Standard Modules)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
0920-1273
Phase 9 Core Mail Questionnaire – English
Att 8e - PRAMS Livebirth Phase 9 Core Mail Questionnaire_ENGLISH.docx
NA
No
Fillable Fileable
Form and Instruction
0920-1273
Phase 9 Core Mail Questionnaire – Spanish
Att 8f - PRAMS Livebirth Phase 9 Core Mail Questionnaire_SPANISH.docx
NA
No
Fillable Fileable
Form and Instruction
0920-1273
Phase 9 Core Phone Questionnaire – English
Att 8g - PRAMS Livebirth Phase 9 Core Phone Questionnaire_ENGLISH.pdf
NA
Yes
Yes
Fillable Fileable
Form and Instruction
0920-1273
Phase 9 Core Phone Questionnaire – Spanish
Att 8h - PRAMS Livebirth Phase 9 Core Phone Questionnaire_SPANISH.docx
NA
Yes
Yes
Fillable Fileable
Form and Instruction
0920-1273
Phase 9 Core Web Questionnaire – English
Att 8i - PRAMS Livebirth Phase 9 Core Web Questionnaire_ENGLISH.docx
NA
Yes
Yes
Fillable Fileable
Form and Instruction
0920-1273
Phase 9 Core Web Questionnaire – Spanish
Att 8j - PRAMS Livebirth Phase 9 Core Web Questionniare_SPANISH.docx
NA
Yes
Yes
Fillable Fileable
Form and Instruction
0920-1273
Phase 9 Standard Mail Questionnaire – English
Att 10e - PRAMS Livebirth Phase 9 Standard Mail Questionnaire_ENGLISH.docx
NA
No
Fillable Fileable
Form and Instruction
0920-1273
Phase 9 Standard Mail Questionnaire – Spanish
Att 10f - PRAMS Livebirth Phase 9 Standard Mail Questionnaire_SPANISH.docx
NA
No
Fillable Fileable
Form and Instruction
0920-1273
Phase 9 Standard Phone Questionnaire – English
Att 10g - PRAMS Livebirth Phase 9 Standard Phone Questionnaire_ENGLISH.pdf
NA
Yes
Yes
Fillable Fileable
Form and Instruction
0920-1273
Phase 9 Standard Phone Questionnaire – Spanish
Att 10h - PRAMS Livebirth Phase 9 Standard Phone Questionnaire_SPANISH.pdf
NA
Yes
Yes
Fillable Fileable
Form and Instruction
0920-1273
Phase 9 Standard Web Module – English
Att 10i - PRAMS Livebirth Phase 9 Standard Web Module_ENGLISH.docx
NA
Yes
Yes
Fillable Fileable
Form and Instruction
0920-1273
Phase 9 Standard Web Module – Spanish
Att 10j - PRAMS Livebirth Phase 9 Standard Web Module_SPANISH.docx
NA
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 %
Requested
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
SSA
1273 PRAMS SSA 04_10_25_clean.docx
04/16/2025
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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