Reception, informed consent, medical releases

The Hispanic Community Health Study/ Study of Latinos (HCHS/SOL)(NHLBI)

Documents and Forms

Document Name Document Type
Form 1 Reception, informed consent, medical releases Form and Instruction
1 SOL IC English SOL IC English FINAL 27 Dec 2013.pdf Form and Instruction
SOL IC Spanish FINAL 27 Dec 2013.pdf SOL IC Spanish IC Document

Information Collection (IC) Details

IC Title:	Reception, informed consent, medical releases	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	SOL IC English	SOL IC English FINAL 27 Dec 2013.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 13,878	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	13,878	13,878
Annual IC Time Burden (Hours)	4,626	4,626
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SOL IC Spanish	SOL IC Spanish FINAL 27 Dec 2013.pdf	06/23/2014

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