Form 1.o Survey

OMB# 0925-0543
Exp. 06/30/2010

Urine Collection Information Sheet

Urine collection
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We will be collecting a urine specimen, using procedures similar to those used in
doctors’ offices.

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We will ask you to urinate into a small plastic cup. You do not need to fill the cup,
but we hope that you will be able to fill the cup at least half full.

•

We will be measuring phytoestrogens, plant-based chemicals that may be there as a
result of eating certain foods such as soy and flaxseed.

•

We will also measure creatinine to determine the concentration of your urine.

Public reporting burden for this collection of information is estimated to average 3 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information. An agency may not conduct or
sponsor, and a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project
Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974.