Appendix A A.2.3.f.1
OMB #: 0925-xxxx
Expiration Date: xx/xxxx
National Children’s Study
As part of the National Children’s Study, we are asking you to collect a sample of your urine.
This kit has everything you will need to collect the sample including: a pre-labeled urine collection cup with lid and 2 paper towels.
Instructions
Wash your hands with soap and water.
Lay out a paper towel on a flat surface. Unscrew the lid from the cup and place it on the paper towel with the inside part of the lid facing down. Do not touch the inside of the lid or the cup. Do not allow the inside of the collection cup or the inside of the lid to come in contact with any parts of your body, clothing, or bathroom surfaces.
Start urinating into the toilet, then urinate directly into the collection cup. If possible, fill the cup at least half full. Do not fill to overflowing.
Screw the lid on the collection cup immediately so that the urine is only briefly exposed to the air.
Use the other paper towel to wipe off the outside of the cup.
Remember to wash your hands after collecting the sample.
Give the cup back to the Study staff, being careful not to tip it.
____________________________________________________________
If you have any questions please ask.
Thank you for providing this sample!
Public reporting burden for this collection of information is estimated to average 7 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, ATTN: PRA (0925-xxxx*). Do not return the completed form to this address.
Revised 9/8/08
| File Type | application/msword |
| File Title | National Children’s Study |
| File Modified | 2008-09-19 |
| File Created | 2008-09-19 |