Adult-Focused Biospecimen Collection (Birth)

Continuation of National Children's Study Vanguard (Pilot) Study Data Collection: Study Visits through 60-Months

Documents and Forms

Document Name Document Type
Form 32.2 Adult-Focused Biospecimen Collection (Birth) Form and Instruction
32.2 Survey AdultUrineInstrument.docx Form and Instruction
32.3 Survey AdultMicrobiomeSwabInstrument.docx Form and Instruction
32.5 Survey BreastMilkSAQ.docx Form and Instruction
32.7 Survey BreastMilkKitDistributionInstrument.docx Form and Instruction
32.8 Survey BreastMilkPickUpInstrument.docx Form and Instruction
32.4 Survey Birth_CordBloodInstrument.docx Form and Instruction
32.6 Survey Birth_PlacentaInstrument.docx Form and Instruction
32.9 Survey Birth_AdultBiospecimenPickUpInstrument.docx Form and Instruction
32.10 Survey AdultBloodPreScreeningInstrument.docx Form and Instruction
32.1 Survey AdultBloodInstrument.docx Form and Instruction
BreastMilkKitLetter.docx BreastMilkKitLetter IC Document
AdultUrineInstructions.doc AdultUrineInstructions IC Document
BreastMilkInstructions.docx BreastMilkInstructions IC Document
AdultMicrobiomeRectalSwabInstructions.docx AdultMicrobiomeRectalSwabInstructions IC Document

Information Collection (IC) Details

IC Title:	Adult-Focused Biospecimen Collection (Birth)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	32.2	Survey	AdultUrineInstrument.docx	Yes	Yes	Paper Only
Form and Instruction	32.3	Survey	AdultMicrobiomeSwabInstrument.docx	Yes	Yes	Paper Only
Form and Instruction	32.5	Survey	BreastMilkSAQ.docx	Yes	Yes	Paper Only
Form and Instruction	32.7	Survey	BreastMilkKitDistributionInstrument.docx	Yes	Yes	Paper Only
Form and Instruction	32.8	Survey	BreastMilkPickUpInstrument.docx	Yes	Yes	Paper Only
Form and Instruction	32.4	Survey	Birth_CordBloodInstrument.docx	Yes	Yes	Paper Only
Form and Instruction	32.6	Survey	Birth_PlacentaInstrument.docx	Yes	Yes	Paper Only
Form and Instruction	32.9	Survey	Birth_AdultBiospecimenPickUpInstrument.docx	Yes	Yes	Paper Only
Form and Instruction	32.10	Survey	AdultBloodPreScreeningInstrument.docx	Yes	Yes	Paper Only
Form and Instruction	32.1	Survey	AdultBloodInstrument.docx	Yes	Yes	Paper Only

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: 253	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	253	253
Annual IC Time Burden (Hours)	358	358
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
BreastMilkKitLetter	BreastMilkKitLetter.docx	11/06/2013
AdultUrineInstructions	AdultUrineInstructions.doc	11/07/2013
BreastMilkInstructions	BreastMilkInstructions.docx	11/07/2013
AdultMicrobiomeRectalSwabInstructions	AdultMicrobiomeRectalSwabInstructions.docx	11/07/2013

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