OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

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

OMB 0920-1217 ยท HHS/CDC.

OMB 0920-1217

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Parents of ZIKV-positive Infant - Infant Follow-Up QuestionnaireForm and Instruction
Parents of ZIKV-positive Infants - Infant Enrollment and Delivery QuestionnaireForm and Instruction
Zika-positive Pregnant Women - Pregnant Women Follow-Up QuestionnaireForm and Instruction
Zika-positive Pregnant Women - Pregnant Women Symptom QuestionnaireForm and Instruction
Zika-positive Pregnant Women - Pregnant Women Enrollment QuestionnaireForm and Instruction
Zika-positive Pregnant Women - Pregnant Women Screening FormForm and Instruction
Part B_ZIRP_CLEAN.docxSupporting Statement B
Part A_ZIRP_CLEAN.docxSupporting Statement A
List of Attachments.docx Supplementary Document
Att E3-Amendment #1 approval.docx Supplementary Document
Att E2- UPR IRB approval.pdf Supplementary Document
Att E1- 7005 IRB Submission Approval.docx Supplementary Document
Att D3 - Agreement to abide by restrictions.docx Supplementary Document
Att D2 - FTE Nondisclosure.DOCX Supplementary Document
Att D1 - Assurance of Confidentiality Zika Surveillance.doc Supplementary Document
60 Day FRN.pdf Supplementary Document
Att A- Section 301_PHS_Act (42 U.S.C. 241).docx Supplementary Document
Parents of ZIKV-positive Infant - Infant Follow-Up Questionnaire Form and Instruction
Parents of ZIKV-positive Infants - Infant Enrollment and Delivery Questionnaire Form and Instruction
Zika-positive Pregnant Women - Pregnant Women Follow-Up Questionnaire Form and Instruction
Zika-positive Pregnant Women - Pregnant Women Symptom Questionnaire Form and Instruction
Zika-positive Pregnant Women - Pregnant Women Enrollment Questionnaire Form and Instruction
Zika-positive Pregnant Women - Pregnant Women Screening Form Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201710-0920-006 New collection (Request for a new OMB Control Number) 2017-11-13 Approved without change