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Federal forms, ICRs, and supporting documents

Information Collection

[NIOSH] Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in Lab/Simulator-based Setting

IC 278792 under ICR 202506-0920-001 · OMB 0920-1441.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form Motion Sickness pr
0920-26-0012 [NIOSH] Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in Lab/Simulator-based Setting		 Form
Form Informed Consent
0920-26-0012 [NIOSH] Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in Lab/Simulator-based Setting		 Form
Form Demographics/ cons
0920-26-0012 [NIOSH] Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in Lab/Simulator-based Setting		 Form
Form Post Test Question
0920-26-0012 [NIOSH] Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in Lab/Simulator-based Setting		 Form
Motion Sickness pr 0920-26-0012
Attachment 3 - Screening Questions for Participation.docx 		Form
Informed Consent 0920-26-0012
Attachment 5 - Consent to be in a Research Study.docx 		Form
Demographics/ cons 0920-26-0012
Attachment 7 - Data Collection Sheet_Clean.docx 		Form
Post Test Question 0920-26-0012
Attachment 8 - Post Test Questionnaire.docx 		Form
3. NIOSH DSR genIC_Request to Debit Hours_Police Cruiser Design_Clean.docx
GenIC Request		IC Document
Attachment 10 - OSH Act 1970_Authorizing Legislation.pdf
Authorizing Legislation		IC Document
Attachment 13 - Email PAD Approval.pdf
PAD Approval		IC Document
Attachment 12 - PIA for Privacy ACT Determination (PAD) CSPO 09102025 (2).pdf
PIA for Privacy ACT Determination		IC Document
Attachment 11 - IRB Approval.pdf
IRB Approval		IC Document
Attachment 1 - Recruitment Flyer.docx
Recruitment		IC Document
Attachment 2 - Sample Email to Police Contact.docx
Sample Email to Police Contact		IC Document
Attachment 9 - Record of Test Subject Participation.docx
Attachment 9 - Record of Test Subject Participation		IC Document
Attachment 6 - An Illustration of the Excel Datasheet_Clean.docx
An Illustration of the Excel Datasheet		IC Document
4. NIOSH DSR genIC_Sampling Plan_Police Cruiser Design_Clean.docx
Sampling Plan		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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
Form Motion Sickness prescreening Questionnaire Yes Yes Fillable Fileable
Form Informed Consent Yes Yes Fillable Fileable
Form Demographics/ construction and robot experience Yes Yes Fillable Fileable
Form Post Test Questionnaire Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 230 0 230 0 0 0
Annual IC Time Burden (Hours) 41 0 41 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
GenIC Request 01/27/2026
Authorizing Legislation 01/20/2026
PAD Approval 01/20/2026
PIA for Privacy ACT Determination 01/20/2026
IRB Approval 01/20/2026
Recruitment 01/20/2026
Sample Email to Police Contact 01/20/2026
Attachment 9 - Record of Test Subject Participation 01/20/2026
An Illustration of the Excel Datasheet 01/27/2026
Sampling Plan 01/27/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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