Eligibility Screening Form

Supplemental Measurements for Exploratory Research regarding Exposure during Activities Conducted on Synthetic Turf Fields with Tire Crumb Rubber Infill

OMB: 0923-0062

IC ID: 235808

Information Collection (IC) Details

View Information Collection (IC)

Eligibility Screening Form 0923-0062
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0923-0062 Eligibility Screener P_AppxN2_FieldUserEligScreen 20210222 cln.docx Yes No Fillable Fileable

Health Public Health Monitoring

 

220 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 220 0 0 0 0 220
Annual IC Time Burden (Hours) 18 0 0 0 0 18
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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