Follow-up Telephone Questionaire

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

Documents and Forms

Document Name Document Type
Form 1 Follow-up Telephone Questionaire Form and Instruction
1 Active Follow-up Sub-cohort Att_03 Follow-Up Telephone Questionnaire_12042013.pdf Form and Instruction
Att_02 Follow-up Lead Letter.pdf Att_02 Follow-up Lead Letter IC Document
Att_04 Follow-up Questionnaire Summary of Changes.pdf Att_04 Follow-up Questionnaire Summary of Changes IC Document

Information Collection (IC) Details

IC Title:	Follow-up Telephone Questionaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Active Follow-up Sub-cohort	Att_03 Follow-Up Telephone Questionnaire_12042013.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40,000	40,000
Annual IC Time Burden (Hours)	20,000	20,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att_02 Follow-up Lead Letter	Att_02 Follow-up Lead Letter.pdf	01/29/2014
Att_04 Follow-up Questionnaire Summary of Changes	Att_04 Follow-up Questionnaire Summary of Changes.pdf	01/29/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.