Information Collection

[NCHS] Dual Energy X-ray Absorptiometry (DXA) and Hematology Analyzer and Blood Collection Tube Crossover Studies

IC 272340 under ICR 202303-0920-006 · OMB 0920-1208.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1208 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
OMB Control Header and Burden Statement DXA Crossover.docx	Other-OMB Header and Burden Statemen
OMB Control Header and Burden Statement Hematology Comparison.docx	Other-OMB Header and Burden Statemen
Attachment 1_Description of study and eligibility questionnaire_2024OCT01.docx Description of Study and Eligibility Questionnaire	IC Document
Attachment 2a_Informed Consent_DXA Only_2024OCT01.docx Informed Consent DXA Only	IC Document
Attachment 2b_Informed Consent_Hematology Only_2024OCT01.docx Informed Consent Hematology Only	IC Document
Attachment 2c_Informed Consent_DXA & Hematology and Blood Tube Studies_2024OCT01.docx Informed Consent DXA and Hematology and Blood Tube	IC Document
Attachment 3_Cover letter & report of findings_2024OCT01.docx Cover Letter and Report of Findings	IC Document
Attachment 4_ERB approval_2024OCT17.docx Research Determination	IC Document
DXA Hematology_DevProj_GenIC Supporting Statement A_10.31.24_final.docx SSA	IC Document
DXA Hematology_DevProj_GenIC Supporting Statement B_10.31.24.docx SSB	IC Document

IC Title:

[NCHS] Dual Energy X-ray Absorptiometry (DXA) and Hematology Analyzer and Blood Collection Tube Crossover Studies

Agency IC Tracking Number:

0920-1208-25BF

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-OMB Header and Burden Statement			OMB Control Header and Burden Statement DXA Crossover.docx		No		Fillable Fileable
Other-OMB Header and Burden Statement			OMB Control Header and Burden Statement Hematology Comparison.docx		No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 70

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	70	70
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Description of Study and Eligibility Questionnaire	Attachment 1_Description of study and eligibility questionnaire_2024OCT01.docx	11/14/2024
Informed Consent DXA Only	Attachment 2a_Informed Consent_DXA Only_2024OCT01.docx	11/14/2024
Informed Consent Hematology Only	Attachment 2b_Informed Consent_Hematology Only_2024OCT01.docx	11/14/2024
Informed Consent DXA and Hematology and Blood Tube	Attachment 2c_Informed Consent_DXA & Hematology and Blood Tube Studies_2024OCT01.docx	11/14/2024
Cover Letter and Report of Findings	Attachment 3_Cover letter & report of findings_2024OCT01.docx	11/14/2024
Research Determination	Attachment 4_ERB approval_2024OCT17.docx	11/14/2024
SSA	DXA Hematology_DevProj_GenIC Supporting Statement A_10.31.24_final.docx	11/14/2024
SSB	DXA Hematology_DevProj_GenIC Supporting Statement B_10.31.24.docx	11/14/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.