One-Time Query for an Organization

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One-Time Query for an Organization Form and Instruction

Non-visible Questions
Label

PDF Name (step) Location

Organization
Description

One-Time Query Below
Text
for an
Organization Entry
Organization (1) Type

Respons
e Input
Item

Visibility
Trigger

Other

The field is
displayed if the
user selects an
organization
type that
requires a
description.

FDA (Federal
One-Time Query Below
Text
Food and Drug for an
checkbox
Entry
Administration) Organization (1) "Does the
subject have
a FDA or
CLIA
identificatio
n number?"

The field is
Selecting the
displayed if the checkbox displays
user selects
FDA and CLIA text
the checkbox entry fields.
for "Does the
subject have a
FDA or CLIA
identification
number?"

CLIA (Clinical
Laboratory
Improvement
Act)

One-Time Query Below FDA
for an
text entry
Organization (1)

Text
Entry

The field is
Selecting the
displayed if the checkbox displays
user selects
FDA and CLIA text
the checkbox entry fields.
for "Does the
subject have a
FDA or CLIA
identification
number?"

Entity Selection One-Time Query After step 1
for an
Subject
Organization (2) Information

Check
boxes

Entity
All entities are
Selection is
listed for which the
only displayed user is authorized
if the entity is to query.
authorized to
act as an agent
to query on
behalf of other
entities.

State Changes
Label

PDF Name

Item Type

Trigger

OMB Number: One-Time
0906-0081
Query for an
Expiration
Organization
Date:
mm/dd/yyyy

Modal

When the user selects the link the
modal is displayed with the public
burden statement content.

Subjects
Available

One-Time
Query for an
Organization

Table

When the user selects the option to
enroll from their subject database,
the summary table of the subjects
with previously saved subject
information is displayed. The user
select one or more names from the
table, then select continue to enter
payment information.

License
Number

One-Time
Query for an
Organization

Text Entry

The field is disabled if the user
selects the "No/ Not sure" option for
"Does the organization have a
license?"