Information Collection Request
[ATSDR] National Amyotrophic Lateral Sclerosis (ALS) Registry
ICR 202301-0923-001 · OMB 0923-0041 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0923-0041 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Follow-up Questions - ALS-associated and Clinical Factors |
Form and Instruction | New | Repair queued |
| Follow-up Questions - Environmental Factors |
Form and Instruction | New | Repair queued |
| Follow-up Questions - Lifestyle Information |
Form and Instruction | New | Repair queued |
| Follow-up Questions - Demography |
Form and Instruction | New | Repair queued |
| ALS Biorepository Collection Form- Saliva |
Form | Modified | Repair queued |
| National Office Outreach Reporting |
Form | Modified | Repair queued |
| Outreach Reporting Form for Chapters and Districts |
Form | Modified | Repair queued |
| Annual Update for Projects Receiving Specimens or Data |
Form | Modified | Repair queued |
| ALS Registry Research Application |
Form and Instruction | Modified | Repair queued |
| ALS Biorepository Specimen Processing |
Form | Modified | Repair queued |
| ALS DIsease Progression Survey |
Form | Modified | Repair queued |
| Essential Questionnaire |
Form and Instruction | Modified | Repair queued |
| ALS Case Registration |
Form | Modified | Repair queued |
| ALS Validation Questions |
Form | Modified | Repair queued |
 P_AppS.B-6b COVID-19 Biorepostiory InfoSht_042821.docx |
Supplementary Document | Uploaded 2023-01-17 | Repair queued |
| P_AppS.B-6a COVID-19 Restart Plan 04282021.docx |
Supplementary Document | Uploaded 2023-01-17 | Repair queued |
| P_AppF Privacy Statement.docx |
Supplementary Document | Uploaded 2023-01-17 | Repair queued |
| P_AppE7 NCHS Comments Surveys.docx |
Supplementary Document | Uploaded 2023-01-17 | Repair queued |
| P_AppE - Survey Introduction_final.docx |
Supplementary Document | Uploaded 2023-01-17 | Repair queued |
| P_AppD4 Biorepository Saliva Consent.docx |
Supplementary Document | Uploaded 2023-01-17 | Repair queued |
| P_AppD3 Biorepository Postmortem Consent.docx |
Supplementary Document | Uploaded 2023-01-17 | Repair queued |
| P_AppD2 Biorepository Consent.docx |
Supplementary Document | Uploaded 2023-01-17 | Repair queued |
 P_AppD1 ALS Registry Consent Form.jpeg |
Supplementary Document | Uploaded 2023-01-17 | Repair queued |
| 0 - List of Attach and Append.docx |
Supplementary Document | Uploaded 2023-01-17 | Repair queued |
 Att9 Prevalence Rate State 4yr avg.xlsx |
Supplementary Document | Uploaded 2023-01-12 | Repair queued |
| Att8 Survey Burden Calculation.docx |
Supplementary Document | Uploaded 2023-01-12 | Repair queued |
 Att7 Biorepository Pilot Study Report.pdf |
Supplementary Document | Uploaded 2023-01-12 | Repair queued |
| Att5 Privacy Impact Assessment 2020.pdf |
Supplementary Document | Uploaded 2023-01-12 | Repair queued |
| Att4 IRB Approval Memo.docx |
Supplementary Document | Uploaded 2023-01-12 | Repair queued |
| Att3 Summary of Changes.docx |
Supplementary Document | Uploaded 2023-01-12 | Repair queued |
| Att2 60-day FRN.pdf |
Supplementary Document | Uploaded 2023-01-12 | Repair queued |
| Att1 Public Law 110-373.docx |
Supplementary Document | Uploaded 2023-01-12 | Repair queued |
| 0- SSB National ALS Registry.docx |
Supporting Statement B | Uploaded 2023-01-12 | Repair queued |
| 0- SSA National ALS Registry_final.docx |
Supporting Statement A | Uploaded 2023-01-12 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 257949 |  Follow-up Questions - ALS-associated and Clinical Factors |
Form and Instruction | New | |
| 257948 | Follow-up Questions - Environmental Factors |
Form and Instruction | New | |
| 257947 | Follow-up Questions - Lifestyle Information |
Form and Instruction | New | |
| 257946 | Follow-up Questions - Demography |
Form and Instruction | New | |
| 224351 | ALS Biorepository Collection Form- Saliva |
Form | Modified | |
| 222089 | National Office Outreach Reporting |
Form | Modified | |
| 222088 | Outreach Reporting Form for Chapters and Districts |
Form | Modified | |
| 222087 | Annual Update for Projects Receiving Specimens or Data |
Form | Modified | |
| 222085 | ALS Registry Research Application |
Form and Instruction | Modified | |
| 222083 | ALS Biorepository Specimen Processing |
Form | Modified | |
| 192032 | ALS DIsease Progression Survey |
Form | Modified | |
| 192031 | Essential Questionnaire |
Form and Instruction | Modified | |
| 192030 | ALS Case Registration |
Form | Modified | |
| 192029 | ALS Validation Questions |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/TSDR |
| OMB Control No | 0923-0041 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202105-0923-002 |
| Agency Tracking No | 0923-0041 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |