Provider-Based: Pregnancy Visit 2 Blood and Urine Collection

OMB Control Number: 0925-0593

Expiration Date: 07/31/2013

Urine Collection Instructions, Phase II

National Children’s Study

Urine Collection Instructions

As part of the National Children’s Study, we ask you to collect a sample of your urine.

Instructions

1. Wash your hands with soap and water.

2. Lay a paper towel on a flat surface. Take the lid off of the collection cup and place it on the paper towel. The inside of the lid should be placed face down on the paper towel. Do not touch the inside of the lid or the collection cup. Do not allow the inside of the collection cup or the inside of the lid to come in contact with any part of your body, clothing, or bathroom surfaces.

3. 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.

4. Put the lid on the collection cup immediately so that the urine is only briefly exposed to the air.

5. Use the paper towel to wipe any urine from the outside of the cup.

6. Remember to wash your hands with soap and water after collecting the sample.

7. Give the collection cup back to the study staff.

If you have any questions please ask study staff. Thank you for providing this sample.

Public reporting burden for this collection of information is estimated to average 5 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 (0925-0593*). Do not return the completed form to this address.