Information Collection Request

Agricultural Health Study: A Prospective Cohort Study of Cancer and Other Diseases Among Men and Women in Agriculture (NCI)

ICR 201002-0925-001 · OMB 0925-0406 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Phase III CATI v. 2 for AHS Form Modified Available
Form 2 Biological Sample Collection Questionnaire (Recently Exposed) Form New Available
Form 1 Biological Sample Collection Questionnaire (Randomly Selected) Form New Available
Form 2 CATI v. 2 Form Modified Available
Form 15F Swab Form and Instruction Modified Available
AHS Biomarker Study - OMB memo 01-07-10.doc Justification for No Material/Nonsubstantive Change Uploaded 2010-01-08 Available
Attach 15B_Buccal Directions Iowa.doc Supplementary Document Uploaded 2008-06-19 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
7302 Phase III CATI v. 2 Instrument for Agricultural Health Study Form ModifiedPhase III CATI v. 2 for AHS
191960 Biological Sample Collection Questionnaire (Recently Exposed) Form NewBiological Sample Collection Questionnaire (Recently Exposed)
191959 Biological Sample Collection Questionnaire (Randomly Selected) Form NewBiological Sample Collection Questionnaire (Randomly Selected)
185933 Buccal Cell Collection for Agricultural Health Study Form ModifiedCATI v. 2
185933 Buccal Cell Collection for Agricultural Health Study Form and Instruction ModifiedSwab

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
10/31/2011 10/31/2011 10/31/2011
6,861 0 6,861
4,140 0 4,140
0 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
Biological Sample Collection Questionnaire (Randomly Selected) 1
Biological Sample Collection Questionnaire (Recently Exposed) 2
Buccal Cell Collection for Agricultural Health Study 15F, 2 ,  
Phase III CATI v. 2 Instrument for Agricultural Health Study 1



Reginfo record details
  No