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Federal forms, ICRs, and supporting documents

Information Collection

Pregnant Women Symptom Questionnaire

IC 227419 under ICR 201706-0920-003 · OMB 0920-1189.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Pregnant Women Symptom Questionnaire
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Pregnant Women Symptom Questionnaire - English Att C3 - Pregnant Woman Symptom Questionnaire.docx NA No   Paper Only
Form and Instruction NA Pregnant Women Symptom Questionnaire - Spanish Att C3 - Pregnant Woman Symptom_final Spanish.docx NA No   Paper Only

Disaster Management Emergency Response

09-20-0136, “Epidemiologic Studies and Surveillance of Disease Problems.”  57 FR 62812

150 0
   
Individuals or Households
 
   0 %

  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 150 0 150 0 0 0
Annual IC Time Burden (Hours) 20 0 20 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.