Blood Draw and Urine Collection

[ATSDR] Human Health Effects of Drinking Water Exposures to Per- and Polyfluoroalkyl Substances (PFAS): A Multi-site Cross-sectional Study

OMB: 0923-0063

IC ID: 239056

Information Collection (IC) Details

View Information Collection (IC)

Blood Draw and Urine Collection
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Blood Draw and Urine Collection Form M_Att14_BloodDrawUrineCollectionForm_20191212_updt.docx No   Paper Only

Health Public Health Monitoring

SORN 09–19–0001, ‘‘Records of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances"  76 FR 4432

3,033 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 3,033 0 0 0 0 3,033
Annual IC Time Burden (Hours) 506 0 0 0 0 506
Annual IC Cost Burden (Dollars) 12,626 0 0 0 0 12,626

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

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