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Mother's Consent Script and Computer Assisted Telephone Interview
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Introductory Phone Script (English) ATT17_BD2_ENG_IntroPhoneScripts_20190318_wSB supplemental intro_CLEAN_FINAL.docx Yes Yes Fillable Fileable
Form and Instruction n/a Introductory Phone Script (Spansih) ATT17_BD2_IntroPhoneScripts_SPAN_20201229_CLEAN.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0010 BDSTEPS_CATI_V8.0.3 Att18_BD-STEPSII_CATI_v8_20201108_ForOMB_Clean final.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0010 BDSTEPS_CATI_V8.0.3_SPAN Att18_BD-STEPSII_CATI_v8_SPAN_20210305_CLEAN.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems   57 FR 62812

3,030 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 3,030 0 0 0 0 3,030
Annual IC Time Burden (Hours) 2,778 0 0 0 0 2,778
Annual IC Cost Burden (Dollars) 27,776 0 0 0 0 27,776

Title Document Date Uploaded
Introductory Letter Stillbirth and BD Att37_BD2_SBSupp_Combined_MainSuppCATI_ IntroductoryLetter_SBwithoutoBD_Eng_08_31_2020_clean_v2.docx 01/21/2021
Introductory Letter Stillbirth and BD Spanish Att37_BD2_SBSupp_Combined_MainSuppCATI_ IntroductoryLetter_SBwithoutoBD_SPAN_08312020_Proofread 12-28-20-clean.docx 01/21/2021
Introductory Letter Stillbirth and BD Controls Att37A_BD2_SBSupp_Combined_MainSuppCATI_ IntroductoryLetter_SBwithBD Controls_English_08_31_2020_Clean_v2.docx 01/21/2021
Introductory Letter Stillbirth and BD Controls Spanish Att37A_BD2_SBSupp_Combined_MainSuppCATI_ IntroductoryLetter_SBwithBD Controls Spanish 08312020_Proofread 12-28-20-Clean.docx 01/21/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.