OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Appx D _Child Follow-up Survey REDCap (Online)

IC 251058 under ICR 202212-0923-001 · OMB 0923-0064.

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

View Information Collection (IC)

Appx D _Child Follow-up Survey REDCap (Online) 0923-0064-22BK
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0923-0064 Evaluating the Association between Serum Concentrations of Per- and Polyfluoroalkyl Substances (PFAS) and Symptoms and Diagnoses of Selected Acute Viral Illnesses Child (< 18 years of age) Follow-up P_ApndxD1_F-UChldSrvy_REDCap.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

Records of Persons Exposed or Potentially Exposed to Hazardous or Toxic Substances (retrievable by name or SSN)  76 FR 4431

104 0
   
Individuals or Households
 
   100 %

  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 416 0 0 0 0 416
Annual IC Time Burden (Hours) 174 0 0 0 0 174
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Follow-up Child Survey (Word) P_ApndxD_F-UChldSrvy (Word)_20221213.docx 12/14/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.