OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Clinic Visit 1

IC 203350 under ICR 201301-0925-001 · OMB 0925-0671.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form
Form and Instruction
Form and Instruction
Form
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Clinic Visit 1
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1.1 Survey Attach 2. Screening Tool.docx Yes Yes Fillable Printable
Form 1.2 Form Attach 4. Participant Contact Information Sheet.docx Yes Yes Paper Only
Form and Instruction 1.4 Survey Attach 7.Visit 1 Stress Questionnaire.docx Yes Yes Paper Only
Form and Instruction 1.5 Survey Attach 10. SLES Checklist.pdf Yes Yes Paper Only
Form 1.3 Attach 6. Demographic and Health Survey Attach 6. Demographic and Health Survey.docx Yes Yes Paper Only

General Science and Innovation Scientific and Technological Research and Innovation

 

700 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 700 0 700 0 0 0
Annual IC Time Burden (Hours) 972 0 972 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attach 15. Study Visit 1 Blood Requisition Form Attach 15. Study Visit 1 Blood Requisition Form.docx 12/06/2012
Attach 17. Visit 1 Blood Processing Protocol Attach 17. Visit 1 Blood Processing Protocol.doc 12/06/2012
Attach 14. Study Hair Collection Protocol Attach 14. Study Hair Collection Protocol.docx 12/06/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.