Pre-Visit Information for Non Fasting Venous Blood Adult Urine Vacuum Collection 20110211

OMB Control Number: 0925-0593

Expiration Date: 07/31/2013

Pre-Visit Instructions for Blood, Urine, and Vacuum Collection, Phase II

National Children’s Study

Pre-Visit Instructions for Blood, Urine, and Vacuum Data Collection

The day before the visit:

We ask that you do not empty your vacuum cleaner bag for 1 day prior to the visit.

The day of your visit:

• We will ask you to collect a small amount of your urine (about 2-1/2 ounces) in a cup we provide.

  • We may use your urine for research studies that include biological, genetic and environmental testing based on the permission you gave during the Informed Consent process.

• We will collect a small amount (about 3 tablespoons) of your blood using a small needle.

  • We are trained medical professionals who know how to take blood safely. People sometimes feel brief pain when blood is taken, and there is a very small risk of infection, bruising, bleeding, or fainting.

  • We may use your blood for research studies that include biological, genetic and environmental testing based on the permission you gave during the Informed Consent process

• We will be collecting a dust sample from the contents in your vacuum cleaner.

  • We may use the dust for research studies that include biological, genetic and environmental testing based on the permission you gave during the Informed Consent process.

Please remember:

• This is a research study and we cannot give you medical advice. None of the Study visits take the place of your regular doctor or clinic visits.

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.