Information Collection Request

Factors Influencing the Transmission of Influenza

ICR 202101-0920-010 · OMB 0920-0888 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Script for Initial Verbal Screening Form and Instruction Modified Available
Initial Verbal Screening Form and Instruction Modified Repair queued
Health Questionnaire for study "Factors Influencing the Transmission of Influenza" Form Modified Available
Health Questionnaire Form Modified Available
Attachment 7 - IRB Approval of Continuation.pdf Supplementary Document Uploaded 2021-02-18 Repair queued
Attachment 2 - Federal Register Notice.pdf Supplementary Document Uploaded 2021-02-18 Repair queued
Attachment 1 - Authorizing Legislation.docx Supplementary Document Uploaded 2021-02-18 Repair queued
Influenza Section B_2021-2-16.docx Supporting Statement B Uploaded 2021-02-18 Repair queued
Influenza Section A_2021-2-18.docx Supporting Statement A Uploaded 2021-02-18 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
228011 Initial Verbal Screening Form and Instruction ModifiedScript for Initial Verbal Screening
228011 Initial Verbal Screening Form and Instruction Modified
196083 Medical Testing Other-Summary of Medical Tests Modified
196082 Health Questionnaire Form ModifiedHealth Questionnaire for study "Factors Influencing the Transmission of Influenza"
196082 Health Questionnaire Form Modified
196081 Informed Consent Other-Informed Consent Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2024 36 Months From Approved 07/31/2021
450 0 450
148 0 148
2,137 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
Health Questionnaire n/a
Informed Consent
Initial Verbal Screening n/a
Medical Testing

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 450 450 0 0 0 0
Annual Time Burden (Hours) 148 148 0 0 0 0
Annual Cost Burden (Dollars) 2,137 0 0 2,137 0 0


Reginfo record details
  No