Biospecimen Collection from Sentinel Cohort (Students and Household Members)

Information Collection on Cause-Specific Absenteeism in Schools (Pittsburgh Location)

Documents and Forms

Document Name Document Type
Biospecimen Collection from Sentinel Cohort (Students and Household Members) Form and Instruction
SMART2 Cohort Project Consent Form 23MAR2015 Attachment G SMART Cohort consent form.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Biospecimen Collection from Sentinel Cohort (Students and Household Members)	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	None	SMART2 Cohort Project Consent Form 23MAR2015	Attachment G SMART Cohort consent form.pdf	None	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0160, Records of Subjects in Health Promotion and Eductaion Studie	FR Citation: 51 FR 42484

Number of Respondents: 1,440	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	1,440	1,440
Annual IC Time Burden (Hours)	120	120
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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