Information Collection Request

Gulf Long-Term Follow-Up Study for Oil Spill Clean-Up Workers and Volunteers (NIEHS)

ICR 201012-0925-004 · OMB 0925-0626 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Gulf Study Participants Form and Instruction New Available
GuLFOMBpart1wkshtREVISEDfinal20110114.doc Supplementary Document Uploaded 2011-01-21 Repair queued
GuLFOMBattachment22NEWQuestionnaire_Sources20110120.xls Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment21NEWAppendix_V_-_Participant_Remuneration_Receipt_Form.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment20NEWAppendix_U_-_Environmental_Monitoring_Data.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment19NEWAppendix_T_-_Active_Follow-up_Sub-cohort_Home_Visit_Instructions_for_Urine_Collection.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment18NEWAppendix_S_-_Active_Follow-up_Sub-cohort_Home_Visit_Instructions.pdf Supplementary Document Uploaded 2011-01-21 Repair queued
GuLFOMBattachment17NEWAppendix_R_-_Active_Follow-up_Sub-cohort_Pre-visit_Appointment_Cover_Letter.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment16DELETED.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment15REVISEDAppendix_Q_-_Report_to_Participants_-_Abnormal_Mailed_Follow-up.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment14REVISEDAppendix_P_-_Report_to_Participants_-_Normal_Mailed_Follow-up.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment13REVISEDAppendix_O_-_Physician_Notification_Letter.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment12REVISEDAppendix_N_-_Report_to_Participants_-_Referral_Guide.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment11REVISEDAppendix_M_-_Participant_Blood_Pressure_Report_-_In-Home.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment10REVISEDAppendix_L_-_Report_to_Participants_-_In-Home.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment9REVISEDAppendix_K_-_Oil_Spill_Work_History_Form.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment6REVISEDAppendix_H_-_Frequently_Asked_Questions.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment5REVISEDAppendix_G_-_Brochure.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment4REVISEDAppendix_F_-_Lead_Letter_-v2.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment3REVISEDAppendix_E_-_Informed_Consent_Quick_Reference_Guide_-_Post_Dec_IRB.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment2REVISEDAppendix_D_-_Informed_Consent_Form-Post_Dec_IRB-v2.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment1SUPP-Appendix_C_-_Lab_Processing_Flow_Sheet_and_Template_for_Specimen_Collection.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment1SUPP-Appendix_B_-_Schedule_of_Procedures_and_Evaluations.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment1SUPP-Appendix_A_Scientific_References.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBattachment1REVISEDProtocol_-_Post_Dec_IRB_-_Final20101221.pdf Supplementary Document Uploaded 2011-01-21 Available
GuLFOMBsuppstBrevised20110120.pdf Supporting Statement B Uploaded 2011-01-21 Available
GuLFOMBattachment13physicianV2.pdf Supplementary Document Uploaded 2010-12-09 Available
GuLFOMBattachment12referralV2.pdf Supplementary Document Uploaded 2010-12-09 Available
GuLFOMBattachment2consentV2.pdf Supplementary Document Uploaded 2010-12-09 Available
GuLFOMBattachment16protocolVer2appABC.pdf Supplementary Document Uploaded 2010-12-08 Available
GuLFOMBattachment15abnormal.pdf Supplementary Document Uploaded 2010-12-08 Available
GuLFOMBattachment14normal.pdf Supplementary Document Uploaded 2010-12-08 Available
GuLFOMBattachment11bp.pdf Supplementary Document Uploaded 2010-12-08 Available
GuLFOMBattachment10homerep.pdf Supplementary Document Uploaded 2010-12-08 Available
GuLFOMBattachment7enrollqx.pdf Supplementary Document Uploaded 2010-12-08 Available
GuLFOMBattachment6faq.pdf Supplementary Document Uploaded 2010-12-08 Available
GuLFOMBattachment5brochure.pdf Supplementary Document Uploaded 2010-12-08 Available
GuLFOMBattachment4leadletter.pdf Supplementary Document Uploaded 2010-12-08 Available
GuLFOMBattachment3consentguide.pdf Supplementary Document Uploaded 2010-12-08 Available
GuLFOMBattachment1protocolVer1.pdf Supplementary Document Uploaded 2010-12-08 Available
GuLFOMBsuppstArevised20110120.pdf Supporting Statement A Uploaded 2011-01-21 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
195744 Gulf Study Participants Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2014 36 Months From Approved
55,000 0 0
52,000 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Gulf Study Participants 1, 2 Enrollment ,   Baseline

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 55,000 0 0 55,000 0 0
Annual Time Burden (Hours) 52,000 0 0 52,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No