OMB control number

Promotion of the National Amyotrophic Lateral Sclerosis (ALS) Registry to Non-referral Centers

OMB 0923-0053 · HHS/TSDR.

OMB 0923-0053

Latest Forms, Documents, and Supporting Material

Document Name
Fax to Determine if Mailing was Received Form and Instruction
Fax to Determine Provider Status Form and Instruction
Att 33 - Human Subjects Exemption Determination.docx Supplementary Document
AppndxS Key Informnt Intervw Thank You Letter.docx Supplementary Document
AppndxQ Key Informnt Intervw Partcpnt Confrmtn Letter.docx Supplementary Document
AppndxP Key Informnt Intervw Invtn Phone Call Chcklst.doc Supplementary Document
AppndxO Key Informnt Intervw Informed Consent.docx Supplementary Document
AppndxN Key Informnt Intervw Partcpnt Invtn Letter.docx Supplementary Document
AppndxM Train-the-trainr Thank You Letter.docx Supplementary Document
AppndxL1 Train-the-trainr Presntn.pdf Supplementary Document
AppndxK Train-the-trainr Partcpnt Confrmtn Letter.docx Supplementary Document
AppndxI Train-the-trainr Partcpnt Invtn Letter.docx Supplementary Document
AppndxH Fax Cover Faild Followp Phone Call2.docx Supplementary Document
AppndxE Fax Cover Rsnd Promtnl Matrls.docx Supplementary Document
AppndxC9 Registry Poster.docx Supplementary Document
AppndxC8 PALS Quick Start Guide.docx Supplementary Document
AppndxC7 Patient Guide Pamphlt.docx Supplementary Document
AppndxC6 Get the Facts Infographic.docx Supplementary Document
AppndxC5 Contin Med Edu Flyer.docx Supplementary Document
AppndxC4 Provdr Guide Pamphlt.docx Supplementary Document
AppndxC2 Tailrd Cover Letter Grp3.docx Supplementary Document
AppndxC1 Tailrd Cover Letter Grp1&2.docx Supplementary Document
Att 9 - Protocol Appendix C3_ATSDR Endorsement Letter.docx Supplementary Document
Att 3 - Public Comment Received to the 60 Day FRN.docx.doc Supplementary Document
Att 1 - ALS Registry Act.docx.doc Supplementary Document
Att 2 - 60-Day FRN_Promotion of the National Amyotrophic Lateral Sclerosis (ALS) Registry to Non-referral Centers.pdf Supplementary Document
SSB Promotion of the National ALS Registry to Non-referral Centers_Clean.doc Supporting Statement B
SSA Promotion of the National ALS Registry to Non-referral Centers_Clean (00000002).doc Supporting Statement A
Key Informant Interview Instruction
Train-the-Trainer Presentation Other-Presentation
Key Informant Interview Invitation Phone Call Instruction
Train-the-Trainer Invitation Phone Call Instruction
Fax to Determine if Mailing was Received Form and Instruction
Follow-Up Phone Call (Three Months Post-Mailing) Instruction
Follow-Up Phone Call (One Week Post-Mailing) Instruction
Fax to Determine Provider Status Form and Instruction
Initial Project Phone Call Instruction

All Historical Document Collections

201507-0923-001

Approved without change

New collection (Request for a new OMB Control Number)

2015-07-15