Aim 1: Consent Form

Experimental and Theoretical Study of Early Detection and Isolation of Influenza

Documents and Forms

Document Name Document Type
Form No Number Aim 1: Consent Form Form
No Number Attachment 5 - Aim 1 Consent Form Lindsley influenza OMB Attach 5 Aim 1 Consent form.doc Form

Information Collection (IC) Details

IC Title:	Aim 1: Consent Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	No Number	Attachment 5 - Aim 1 Consent Form	Lindsley influenza OMB Attach 5 Aim 1 Consent form.doc		Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: Occupational Health Epidemiological Studies	FR Citation: 51 FR 42449

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	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.