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Women's Health Needs STUDY_QUESTIONNAIRE
Women’s Health Needs Study: The Health of US-Resident Women from Countries with Prevalent Female Genital Mutilation/Cutting (FGM/C)
OMB: 0920-1264
IC ID: 234873
OMB.report
HHS/CDC
OMB 0920-1264
ICR 202009-0920-017
IC 234873
( )
Documents and Forms
Document Name
Document Type
Att H2 WHNS_Questionnaire (Somali Translations)_REVISED.docx
Other-WORD Somali translations
Att H4 WHNS_Questionnaire (Arabic Translations)_REVISED.docx
Other-WORD Arabic translations
Att H5 WHNS_Questionnaire (Amharic Translations)_REVISED.docx
Other-WORD Armharic translations
Att H3 WHNS_Questionnaire (French Translations)_NEW.docx
Other-WORD: French Translation
Att H6 WHNS_Questionnaire (Tigrinya Translations)_NEW.docx
Other-WORD: Tigrinya Translation
Att H7 Womens Health Needs Study Questionnaire (Oromo Translations)_NEW.docx
Other-WORD: Oromo Translation
0920-1264 Women's Health Need Study (revised)
Att H1 WHNS_Questionnaire (English)_Clean.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Women's Health Needs STUDY_QUESTIONNAIRE
Agency IC Tracking Number:
0920-20OZ
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
0920-1264
Women's Health Need Study (revised)
Att H1 WHNS_Questionnaire (English)_Clean.docx
No
Fillable Fileable
Other-WORD Somali translations
Att H2 WHNS_Questionnaire (Somali Translations)_REVISED.docx
No
Paper Only
Other-WORD Arabic translations
Att H4 WHNS_Questionnaire (Arabic Translations)_REVISED.docx
No
Paper Only
Other-WORD Armharic translations
Att H5 WHNS_Questionnaire (Amharic Translations)_REVISED.docx
No
Paper Only
Other-WORD: French Translation
Att H3 WHNS_Questionnaire (French Translations)_NEW.docx
No
Paper Only
Other-WORD: Tigrinya Translation
Att H6 WHNS_Questionnaire (Tigrinya Translations)_NEW.docx
No
Paper Only
Other-WORD: Oromo Translation
Att H7 Womens Health Needs Study Questionnaire (Oromo Translations)_NEW.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,000
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
2,000
0
0
0
0
2,000
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.