OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Assessment to Estimate the Effect of Community-Wide Vector Control Initiatives on Zika Virus Transmission in Puerto Rico, 2016

OMB 0920-1137 ยท HHS/CDC.

OMB 0920-1137

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Refusal Demographics FormForm and Instruction
Individual specimen collection of blood, urine, and salivaForm
Individual QuestionnaireForm and Instruction
Household QuestionnaireForm and Instruction
0920-1137 change request.docx Justification for No Material/Nonsubstantive Change
Revised SSB Vector Control Initiatives_PR 12SEP2016.docxSupporting Statement B
Emergency Zika SSA - Vector Control Initiatives in PR_OMB 09 21 2016_RMB_FINAL.docxSupporting Statement A
Att I - Household Tracking Form.docx Supplementary Document
Att F - Assent for Children aged 5-14 SPANISH.docx Supplementary Document
Att F - Assent for Children aged 5-14.docx Supplementary Document
Att E - Adult Consent Form SPANISH.docx Supplementary Document
Att E - Adult Consent Form.docx Supplementary Document
Att D - Household and Individual Consent Form SPANISH (002).docx Supplementary Document
Att D - Household and Individual Consent Form.docx Supplementary Document
Att C - 6901 CDC IRB Approval Memo_New-Expedited 8 2 16.docx Supplementary Document
Att B - 60-Day FRN.docx Supplementary Document
Emergency Review Request Memo - Signed.pdf Supplementary Document
Refusal Demographics Form Form and Instruction
Individual specimen collection of blood, urine, and saliva Form
Individual Questionnaire Form and Instruction
Household Questionnaire Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201609-0920-018 No material or nonsubstantive change to a currently approved collection 2016-09-27 Approved without change
201608-0920-013 New collection (Request for a new OMB Control Number) 2016-09-13 Approved with change