Attachments: 17.5 -17.6; 18; 22.2 consent forms, show cards, and dust questionnaire

Agricultural Health Study: A Prospective Cohort Study of Cancer and Other Diseases Among Men and Women in Agriculture

OMB: 0925-0406

IC ID: 208235

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

View Information Collection (IC)

Attachments: 17.5 -17.6; 18; 22.2 consent forms, show cards, and dust questionnaire
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 BEEA Show Cards Attachment 17-5 17-6_BEEA_ShowCards_burden.pdf Yes No Paper Only
Form and Instruction 2 BEEA Consent Form - Dust Attachment 18_BEEA_Consent Forms_Dust.pdf Yes No Paper Only
Form and Instruction 3 BEEA Dust Specimen Questionnaire Attachment 22-2_Dust Questionnaire_columns.doc Yes No Paper Only

Health Consumer Health and Safety

 

160 0
   
Private Sector Farms
 
   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 0 0 -160 0 0 160
Annual IC Time Burden (Hours) 0 0 -53 0 0 53
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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