OMB control number

Biomonitoring of Great Lakes Populations Program

OMB 0923-0044 · HHS/TSDR.

OMB 0923-0044

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form 0923-0044 Michigan Biomonitoring of Great Lakes Populations	Form and Instruction
Form 0923-0044 Mi Informed Consent for Repeat Appointments	Form and Instruction
Form 0923-0044 Michigan Department of Community Health Telephone Questions for Scheduling (repeated appointments)	Form and Instruction
MI Contact Information Sheet	Form
NY - Network Questions - Burmese	Form
NY Interview - Burmese	Form
NY Consent - Burmese	Form
NY Screener - Burmese	Form
NY Questionnaire	Form
NY Consent	Form
NY Responder Script	Form
NY Nonresponder Script	Form
NY Online Screener	Form
NY Mail-in Screener	Form
MN Participation Record	Form
MN Clinic Visit Form	Form
MN Participant Questionnaire	Form
MN Contact Information	Form
MN Consent	Form
MN Refusal Questions	Form
MN Recruitment Script	Form
MI Biomonitoring Questionnaire	Form
MI Informed Consent	Form
MI Scheduling Questionnaire	Form
MI Screener	Form
0923-0044 Change Request Justification 20140724.docx	Justification for No Material/Nonsubstantive Change
GreatLakes_SSB_20130911_clean[1].doc	Supporting Statement B
0923-0044 Change Request Justification 20130912(1).docx	Justification for No Material/Nonsubstantive Change
Att6a_NY_FctSht_LA_20120619.docx	Supplementary Document
Att4a1._MI_Dtrt_AOC_Brochure_20120712.pdf	Supplementary Document
GreatLakes_modified SSA_20140724.docx	Supporting Statement A
Michigan Biomonitoring of Great Lakes Populations	Form and Instruction
Mi Informed Consent for Repeat Appointments	Form and Instruction
Michigan Department of Community Health Telephone Questions for Scheduling (repeated appointments)	Form and Instruction
MI Contact Information Sheet	Form
NY - Network Questions - Burmese	Form
NY Interview - Burmese	Form
NY Consent - Burmese	Form
NY Screener - Burmese	Form
NY Questionnaire	Form
NY Consent	Form
NY Responder Script	Form
NY Nonresponder Script	Form
NY Online Screener	Form
NY Mail-in Screener	Form
MN Participation Record	Form
MN Clinic Visit Form	Form
MN Participant Questionnaire	Form
MN Contact Information	Form
MN Consent	Form
MN Refusal Questions	Form
MN Recruitment Script	Form
MI Biomonitoring Questionnaire	Form
MI Informed Consent	Form
MI Scheduling Questionnaire	Form
MI Screener	Form

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
201407-0923-001	No material or nonsubstantive change to a currently approved collection	2014-08-19	Approved without change
201309-0923-001	No material or nonsubstantive change to a currently approved collection	2013-09-23	Approved without change
201308-0923-001	No material or nonsubstantive change to a currently approved collection	2013-08-19	Approved without change
201304-0923-002	No material or nonsubstantive change to a currently approved collection	2013-04-12	Approved without change
201210-0923-001	New collection (Request for a new OMB Control Number)	2012-10-03	Approved without change
201203-0923-001	New collection (Request for a new OMB Control Number)	2012-03-07	Withdrawn