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Federal forms, ICRs, and supporting documents

Information Collection

Individual specimen collection of blood, urine, and saliva

IC 223493 under ICR 201609-0920-018 · OMB 0920-1137.

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

View Information Collection (IC)

Individual specimen collection of blood, urine, and saliva
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form NA Adult Consent Form - English Att E - Adult Consent Form.docx NA No   Paper Only
Form NA Adult Consent Form - Spanish Att E - Adult Consent Form SPANISH.docx NA No   Paper Only
Form NA Assent Children 5-14 - English Att F - Assent for Children aged 5-14.docx NA No   Paper Only
Form NA Assent Children 5-14 - Spanish Att F - Assent for Children aged 5-14 SPANISH.docx NA No   Paper Only

Health Public Health Monitoring

09-20-0113 Epidemic Investigation Case Records Systems Notice  51 FR 42466

500 0
   
Individuals or Households
 
   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 500 0 0 0 0 500
Annual IC Time Burden (Hours) 83 0 0 0 0 83
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.