B.2.3 LOI2-PHYS-15 NCS Visit Information Sheet (for NCS Vanguard Study Participants)

ATTACHMENT B.2.3 VISIT INFORMATION SHEET FOR NCS VANGUARD STUDY PARTICIPANTS OMB NUMBER 0925-0593

LOI2-PHYS-15 EXPIRATION DATE: 7/31/2013

National Children’s Study Visit Information Sheet: LOI2-PHYS-15

Thank you for participating in the National Children’s Study. When you joined the Study, we explained what it means to take part in this important research effort. This sheet gives more details about what we would like to do during this visit.

What will happen during today’s visit?

• This collection is part of a methods study that will examine the most efficient ways to assess variations in physical appearance. This collection will take about 30 minutes to complete. We will take pictures of your baby’s face, hands, and feet. We will also make a ten-second video of your baby’s face and diapered body. A brief physical examination will be completed by trained researchers.

Will I receive money for taking part in today’s visit?

• To thank you for your participation, we will give you $25 for today’s visit.

What if I have questions about this visit?

• If you have any questions about this visit, you can ask the Study representative you are talking with today. If he or she can’t answer a question, we will give you the name and phone number of someone from our local office who can.

Please remember:

• This is a methods study. You can still participate in the National Children’s Study if you do not want to join the methods study.

• Whether or not you stay in the National Children’s Study is your choice.

• If you leave the Study, you can rejoin it later.

• You can decide whether or not you want to stay in the Study.

• If you leave the Study, we will not ask you for any new information, but we will keep using the information you have already given us. We will keep everything that you tell us confidential.

• If we learn that you or someone else is harming you, your child, or others around you, we may be required by law to report this to the police or a social services agency in your community.

• 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.

• We will contact you later to arrange for future visits with you and your child/the child you take care of.

Public reporting burden for this collection of information is estimated to average 30 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.