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SEED - Biosamples (cheek swab and blood)
The Study to Explore Early Development (SEED)
OMB: 0920-0741
IC ID: 178556
OMB.report
HHS/CDC
OMB 0920-0741
ICR 201005-0920-003
IC 178556
( )
Documents and Forms
Document Name
Document Type
Appendix_E.20 Study Start Buccal Consent Dad 2007.doc
Other-WORD
Appendix_E.21 Study Start Cheek Swab Record Sheet 2007 .doc
Other-WORD
Appendix_E 20.1 Informed Consent From Check Swab for Biological Mother and Child Participant.doc
Other-WORD
Appendix_R.2 Study Start Blood Draw form adult 2007.doc
Other-WORD
Appendix_R.2 Study Start Blood Draw form child 2007.doc
Other-WORD
Appendix_E.19 Study Start How to collect Cheek Swab 2007.doc
Appendix_E
IC Document
Appendix_R.1 Biosample Shipping, Processing & Storage.doc
Appendix_R
IC Document
Appendix_E.7 Study Start Frequently Asked Questions on Biosampling 2007 .doc
Appendix_E
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
SEED - Biosamples (cheek swab and blood)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Other-WORD
Appendix_E.20 Study Start Buccal Consent Dad 2007.doc
Yes
Yes
Fillable Printable
Other-WORD
Appendix_E.21 Study Start Cheek Swab Record Sheet 2007 .doc
Yes
Yes
Fillable Printable
Other-WORD
Appendix_E 20.1 Informed Consent From Check Swab for Biological Mother and Child Participant.doc
Yes
Yes
Fillable Printable
Other-WORD
Appendix_R.2 Study Start Blood Draw form adult 2007.doc
Yes
Yes
Fillable Printable
Other-WORD
Appendix_R.2 Study Start Blood Draw form child 2007.doc
No
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems
FR Citation:
57 FR 62812
Number of Respondents:
1,041
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,041
0
-29,037
0
0
30,078
Annual IC Time Burden (Hours)
694
0
-11,668
0
0
12,362
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Appendix_E
Appendix_E.19 Study Start How to collect Cheek Swab 2007.doc
04/15/2010
Appendix_R
Appendix_R.1 Biosample Shipping, Processing & Storage.doc
04/15/2010
Appendix_E
Appendix_E.7 Study Start Frequently Asked Questions on Biosampling 2007 .doc
04/26/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.