OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Zika Postpartum Emergency Response Survey (ZPER) - Puerto Rico 2017

OMB 0920-1183 · HHS/CDC.

OMB 0920-1183

Latest Forms, Documents, and Supporting Material

Document Name
Telephone Follow-Up Survey Form and Instruction
Hospital-based Survey for Fathers Form and Instruction
Hospital-based Survey for Mothers Form and Instruction
SSA - Emergency Zika Package ZPER 12MAY2017.docx Supporting Statement A
Att 6 PRAMS IRB approval.docx Supplementary Document
Att 10 Sampling_ZPER_Protocol_031317.docx Supplementary Document
Att 5b Telephone Introductory Script and Informed Consent_Spanish.docx Supplementary Document
Att 5a Telephone Introductory Script and Informed Consent_English.docx Supplementary Document
Att 4b Telephone Survey Introductory Letter_Spanish.docx Supplementary Document
Att 4a Telephone Survey Introductory Letter_English.docx Supplementary Document
Att 3b Hospital-based Informed Consent _Spanish.docx Supplementary Document
Att 3a Hospital-based Informed Consent_English_OMB_final.docx Supplementary Document
SSB - Emergency Zika Package_ZPER 12MAY2017.docx Supporting Statement B
Zika-ZPER-March2017-OMB Memo.pdf Supplementary Document
60dFRN - published.pdf Supplementary Document
Att 1 - Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document
Telephone Follow-Up Survey Form and Instruction
Hospital-based Survey for Fathers Form and Instruction
Hospital-based Survey for Mothers Form and Instruction

All Historical Document Collections

201704-0920-006

Approved with change

New collection (Request for a new OMB Control Number)

2017-05-15