Prenatal Patient and Parent of Minor Consent

Health Resources and Services Administration’s Evaluation of the Text4baby Program:

Burden associated with Patient Consent

Health center staff will be providing prenatal and post natal patients with informed consent forms to read and sign before participating in the consumer survey and focus groups. The burden below accounts for the time taken for health center staff to distribute consent forms to respondents, and prenatal patients and parents of minors to read and sign the consent forms.

The estimated annualized burden for these activities is as follows:

Instrument	Person Incurring Burden	Number of Respondents	Responses per Respondent	Total Responses	Hours per Response	Total Burden Hours
Prenatal Patient Consent	Health Center Staff	1630	1	1630	0.08	130
	Prenatal Patient	1630	1	1630	0.08	130
Parent-of-Minor Consent	Health Center Staff	195	1	195	0.25	49
	Parent of Minor	195	1	195	0.08	16
Total						325