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Postpartum Survey - 2 months
Prospective Birth Cohort Study Involving Environmental Uranium Exposure in the Navajo Nation
OMB: 0923-0046
IC ID: 201790
OMB.report
HHS/TSDR
OMB 0923-0046
ICR 201511-0923-001
IC 201790
( )
Documents and Forms
Document Name
Document Type
Postpartum Survey - 2 months
Form
Postpartum Survey - 2 months
Att8e Postpart 2Mo.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Postpartum Survey - 2 months
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
none
Postpartum Survey - 2 months
Att8e Postpart 2Mo.docx
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Records of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances
FR Citation:
76 FR 4432
Number of Respondents:
500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
500
0
0
0
0
500
Annual IC Time Burden (Hours)
500
0
0
0
0
500
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.