OMB control number

Zika Virus RNA Persistence in Pregnant Women and Congenitally Exposed Infants in Puerto Rico (ZIRP)

OMB 0920-1189 · HHS/CDC.

OMB 0920-1189

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Infant Follow-Up Questionnaire - SpanishForm and Instruction
Infant Follow-Up Questionnaire - EnglishForm and Instruction
Infant Enrollment and Delivery Questionnaire - SpanishForm and Instruction
Infant Enrollment and Delivery Questionnaire - EnglishForm and Instruction
Pregnant Women Follow-Up Questionnaire - SpanishForm and Instruction
Pregnant Women Follow-Up Questionnaire - EnglishForm and Instruction
Pregnant Women Symptom Questionnaire - SpanishForm and Instruction
Pregnant Women Symptom Questionnaire - EnglishForm and Instruction
Pregnant Women Enrollment Questionnaire - SpanishForm and Instruction
Pregnant Women Enrollment Questionnaire - EnglishForm and Instruction
Pregnant Women Screening Form - SpanishForm and Instruction
Pregnant Women Screening Form - EnglishForm and Instruction
OMB_Part B_ZIRP_full_v1_clean.docxSupporting Statement B
OMB_Part A_ZIRP_full_v1_clean.docxSupporting Statement A
Att E1- 7005 IRB Submission Approval.docx Supplementary Document
Att D3 - Agreement to abide by data restrictions.docx Supplementary Document
Att D2 - FTE Non-disclosure agreement.docx Supplementary Document
Att D1 - Assurance of Confidentiality.docx Supplementary Document
deb lubar signed memo.pdf Supplementary Document
Att B - 60-day notice.pdf Supplementary Document
Att A - Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document
Infant Follow-Up Questionnaire Form and Instruction
Infant Follow-Up Questionnaire Form and Instruction
Infant Enrollment and Delivery Questionnaire Form and Instruction
Infant Enrollment and Delivery Questionnaire Form and Instruction
Pregnant Women Follow-Up Questionnaire Form and Instruction
Pregnant Women Follow-Up Questionnaire Form and Instruction
Pregnant Women Symptom Questionnaire Form and Instruction
Pregnant Women Symptom Questionnaire Form and Instruction
Pregnant Women Enrollment Questionnaire Form and Instruction
Pregnant Women Enrollment Questionnaire Form and Instruction
Pregnant Women Screening Form Form and Instruction
Pregnant Women Screening Form Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201706-0920-003 New collection (Request for a new OMB Control Number) 2017-07-10 Approved without change