OMB control number

Zika virus persistence in body fluids of patients with Zika virus infection in Puerto Rico (ZIPER Study)

OMB 0920-1140 · HHS/CDC.

OMB 0920-1140

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Contact Information FormForm and Instruction
Eligibility FormForm and Instruction
Questionnaire for Men in Semen Sub-StudyForm and Instruction
Baseline and Follow-Up QuestionnaireForm and Instruction
Baseline and Follow-Up Questionnaire - EnglishForm and Instruction
Baseline and Follow-Up Questionnaire - SpanishForm and Instruction
Baseline and Follow-Up Questionnaire - EnglishForm and Instruction
Baseline and Follow-Up Questionnaire - SpanishForm and Instruction
Baseline and Follow-Up Questionnaire - EnglishForm and Instruction
Contact Information FormForm
Participant Eligibility FormForm and Instruction
Baseline and Follow-Up Questionnaire - Spanish 29SEP2016Form and Instruction
Baseline and Follow-Up Questionnaire - English 29SEP2016Form and Instruction
Baseline and Follow-Up Questionnaire - Spanish 29SEP2016Form and Instruction
Baseline and Follow-Up Questionnaire - English 29SEP2016Form and Instruction
Att. L - IRB approval.docx Supplementary Document
Att. M - Informational Flyer.docx Supplementary Document
Att. K - Counseling messages.docx Supplementary Document
Att. J - Laboratory Form.docx Supplementary Document
Att. I - Protocol for specimen collection ESP.docx Supplementary Document
Att. I - Protocol for specimen collection.docx Supplementary Document
Att. F - ZIPER Phone Recruitment Script ESP.docx Supplementary Document
Att. F - ZIPER Phone Recruitment Script.docx Supplementary Document
Att. E - Consent forms ESP.docx Supplementary Document
Att. E - Consent forms.docx Supplementary Document
Att. C - Model coupon.docx Supplementary Document
Att. B - 60-day FRN (0920-1140).pdf Supplementary Document
Att. A - Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document
SSB_0920-1140_2017_Revision.docxSupporting Statement B
SSA_0920-1140_13JUL2017.docxSupporting Statement A
Contact Information Form Form and Instruction
Shedding Eligibility Form Form and Instruction
Questionnaire for Men in Semen Study Form and Instruction
Shedding Questionnaire - Asymptomatics Form and Instruction
Shedding Questionnaire - Asymptomatics Form and Instruction
Shedding Questionnaire - Symptomatics Form and Instruction
Shedding Questionnaire - Symptomatics Form and Instruction
Shedding Questionnaire - Public Health Personnel Form and Instruction
Shedding Questionnaire - Public Health Personnel Form and Instruction
Contact Information Form Form
Shedding Eligibility Form and Instruction
Baseline and Follow-Up Questionnaire - Asymptomatic Form and Instruction
Baseline and Follow-Up Questionnaire - Asymptomatic Form and Instruction
Baseline and Follow-Up Questionnaire - Symptomatic Form and Instruction
Baseline and Follow-Up Questionnaire - Symptomatic Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201707-0920-005 Revision of a currently approved collection 2017-07-14 Approved without change
201606-0920-022 New collection (Request for a new OMB Control Number) 2016-07-13 Approved with change