Information Collection

Bathtub Slip Resistance Study Participation

IC 274952 under ICR 202504-3041-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
MEDICAL HISTORY FORM .docx	Other-
MEDICAL HISTORY FORM .docx	Other-
ASU_IRB_CPSC_II_Consent Form_2024_10_18_new_1.docx	Other-
ASU_IRB_CPSC_II_Consent Form_2024_10_18_new_1.docx	Other-

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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-					No		Paper Only
Other-					No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

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	200	200
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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