OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

ZEN Colombia Study - Zika in Pregnant Women and Children in Colombia

OMB 0920-1142 ยท HHS/CDC.

OMB 0920-1142

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Adult Symptom QuestionnaireForm
Male Partner Enrollment QuestionnaireForm
Male Partner Eligibility QuestionnaireForm
Infant Symptoms QuestionnaireForm
Pregnant Women Follow-Up QuestionnaireForm
Adult Symptom QuestionnaireForm
Pregnant Women Enrollment QuestionnaireForm
Pregnant Women Eligibility QuestionnaireForm
60Day_FRN_ZEN.docx Supplementary Document
ZEN Colombia - Signed OMB memo.pdf Supplementary Document
Att_B9_Male Participant Informed Consent 09222016.docx Supplementary Document
Att_B7_Pregnant Woman Informed Consent 09222016.docx Supplementary Document
OMB_Part B_ZEN_09262016.docxSupporting Statement B
OMB_PartA_ZEN_10272016.docxSupporting Statement A
Att_D_Assurance of Confidentiality Zika Surveillance Final.doc Supplementary Document
Att_C_6921 New Site Restricted Approval.docx Supplementary Document
Att_A_Section 301 of Public Health Service Act (42 U.S.C. 241).docx Supplementary Document
Adult Symptom Questionnaire Form
Male Partner Enrollment Questionnaire Form
Male Partner Eligibility Questionnaire Form
Infant Symptoms Questionnaire Form
Pregnant Women Follow-Up Questionnaire Form
Adult Symptom Questionnaire Form
Pregnant Women Enrollment Questionnaire Form
Pregnant Women Eligibility Questionnaire Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201610-0920-001 New collection (Request for a new OMB Control Number) 2016-10-27 Approved with change