OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Women's Health Needs STUDY_QUESTIONNAIRE

IC 234873 under ICR 202009-0920-017 · OMB 0920-1264.

Documents and Forms
Document Name
Document Type
Other-WORD Somali translations
Other-WORD Arabic translations
Other-WORD Armharic translations
Other-WORD: French Translation
Other-WORD: Tigrinya Translation
Other-WORD: Oromo Translation
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Women's Health Needs STUDY_QUESTIONNAIRE 0920-20OZ
 
No Modified
 
Voluntary
 

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

Health Public Health Monitoring

 

2,000 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 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

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.