OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

A multi-center international hospital-based case-control study of lymphoma in Asia (AsiaLymph) (NCI)

OMB 0925-0654 · HHS/NIH.

OMB 0925-0654

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 9 Attachment 11 Admin Forms InterviewersForm and Instruction
Form 8 Attachment 10 Admin Form pathologistForm and Instruction
Form 7 Attachment 3F Updated Screener and Core Questionnaire Tianjin-ChineseForm and Instruction
Form 6 Attachment 3E Updated Screener and Core Questionnaire Tianjin-EnglishForm and Instruction
Form 5 Attachment 3D Updated Screener and Core Questionnaire Chengdu-ChineseForm and Instruction
Form 4 Attachment 3C Updated Screener and Core Questionnaire Chengdu-EnglishForm and Instruction
Form 3 Attachment 3B Updated Screener and Core Questionnaire Hong-Kong ChineseForm and Instruction
Form 2 Attachment 3A Updated Screener and Core Questionnaire Hong-Kong EnglishForm and Instruction
Form 1 Attachment 5 Occupational Job ModulesForm and Instruction
Form 7 Attachment 3F Updated Screener and Core Questionnaire Tianjin-ChineseForm and Instruction
Form 6 Attachment 3E Updated Screener and Core Questionnaire Tianjin-EnglishForm and Instruction
Form 5 Attachment 3D Updated Screener and Core Questionnaire Chengdu-ChineseForm and Instruction
Form 4 Attachment 3C Updated Screener and Core Questionnaire Chengdu-EnglishForm and Instruction
Form 3 Attachment 3B Updated Screener and Core Questionnaire Hong-Kong ChineseForm and Instruction
Form 2 Attachment 3A Updated Screener and Core Questionnaire Hong-Kong EnglishForm and Instruction
Form 1 Attachment 5 Occupational Job ModulesForm and Instruction
Form 2 Attachment 9 Revised Informed Consent ControlsForm and Instruction
Form 1 Attachment 8 Revised Informed Consent CasesForm and Instruction
Form 6 Attachment 3F Updated Screener and Core Questionnaire Tianjin-ChineseForm and Instruction
Form 5 Attachment 3E Updated Screener and Core Questionnaire Tianjin-EnglishForm and Instruction
Form 4 Attachment 3D Updated Screener and Core Questionnaire Chengdu-ChineseForm and Instruction
Form 3 Attachment 3C Updated Screener and Core Questionnaire Chengdu-EnglishForm and Instruction
Form 2 Attachment 3B Updated Screener and Core Questionnaire Hong-Kong ChineseForm and Instruction
Form 1 Attachment 3A Updated Screener and Core Questionnaire Hong-Kong EnglishForm and Instruction
Form 9 Administrative forms for the InterviewerForm and Instruction
Form 8 Administrative form for the PathologistForm and Instruction
Form 5 Occupational Job Exposure Modules - complete setForm and Instruction
Form 4 Occupational Job Exposure Modules - examplesForm and Instruction
Form 3H Screener and Core Questionnaire-Tianjin (Chinese)Form and Instruction
Form 3G Screener and Core Questionnaire-Tianjin (English)Form and Instruction
Form 3F Screener and Core Questionnaire-Taiwan (Chinese)Form and Instruction
Form 3E Screener and Core Questionnaire-Taiwan (English)Form and Instruction
Form 3D Screener and Core Questionnaire-Chengdu (Chinese)Form and Instruction
Form 3C Screener and Core Questionnaire-Chengdu (English)Form and Instruction
Form 3B Screener and Core Questionnaire-Hong Kong (Chinese)Form and Instruction
Form 3A Screener and Core Questionnaire-Hong Kong (English)Form and Instruction
Form 5 Occupational Job Exposure Modules - complete setForm and Instruction
Form 4 Occupational Job Exposure Modules - examplesForm and Instruction
Form 3H Screener and Core Questionnaire-Tianjin (Chinese)Form and Instruction
Form 3G Screener and Core Questionnaire-Tianjin (English)Form and Instruction
Form 3F Screener and Core Questionnaire-Taiwan (Chinese)Form and Instruction
Form 3E Screener and Core Questionnaire-Taiwan (English)Form and Instruction
Form 3D Screener and Core Questionnaire-Chengdu (Chinese)Form and Instruction
Form 3C Screener and Core Questionnaire-Chengdu (English)Form and Instruction
Form 3B Screener and Core Questionnaire-Hong Kong (Chinese)Form and Instruction
Form 3A Screener and Core Questionnaire-Hong Kong (English)Form and Instruction
Attach-2-consultants.pdf Supplementary Document
Attach-1-AsiaLymph-Revised-Protocol-and-Bibliography.doc Supplementary Document
Attach-18-Memo_Request_Limited_Ethnic_Category_3-2-2012.pdf Supplementary Document
Attach-17-Interviewer-labor-rates.docx Supplementary Document
Attach-16-Pathology-labor-rates.docx Supplementary Document
Attach-15-Translation-of-average-wage-doc-for-Chengdu&Tianjin-highlight.doc Supplementary Document
Attach-14-Hong-Kong-average_salary-2015-Q1-highlight-page31.pdf Supplementary Document
Attach-13-Hourly-salary-calculations-for-each-of-the-three-study-centers-in-AsiaLymph.doc Supplementary Document
Attach-12-AsiaLymph-Study-Organization.pdf Supplementary Document
Attach-7-Script_for_initial_contact_with_potential_study_subjects-revised.doc Supplementary Document
Attach-6E2-Tianjin-Tumor-Hospital-Medical-University-IRB-Approval-English.docx Supplementary Document
Attach-6E1-Tianjin-Tumor-Hospital-Medical-University-IRB-Approval-Original.pdf Supplementary Document
Attach-6D2-West-China-Hospital-Sichuan-University-IRB-Approval-English.docx Supplementary Document
Attach-6D1-West-China-Hospital-Sichuan-University-IRB-Approval-Original.pdf Supplementary Document
Attach-6C-University-of-Hong-Kong-IRB-Approval.pdf Supplementary Document
Attach-6B-NIH-Approval.pdf Supplementary Document
Attach-6A-NCI-IRB-approval.pdf Supplementary Document
SSB_Revised 02-24-2016 (1).docxSupporting Statement B
SSA 10.29.2015.docxSupporting Statement A
30 day FRN.pdf Supplementary Document
Tracking Forms Form and Instruction
Pathology sample request and tracking form Form and Instruction
Core Questionnaire & Occupational Job Module Consented Patient Controls Form and Instruction
Core Questionnaire & Occupational Job Module Consented Patient Controls Form and Instruction
Core Questionnaire & Occupational Job Module Consented Patient Controls Form and Instruction
Core Questionnaire & Occupational Job Module Consented Patient Controls Form and Instruction
Core Questionnaire & Occupational Job Module Consented Patient Controls Form and Instruction
Core Questionnaire & Occupational Job Module Consented Patient Controls Form and Instruction
Core Questionnaire & Occupational Job Module Consented Patient Controls Form and Instruction
Core Questionnaire & Occupational Job Module Form and Instruction
Core Questionnaire & Occupational Job Module Form and Instruction
Core Questionnaire & Occupational Job Module Form and Instruction
Core Questionnaire & Occupational Job Module Form and Instruction
Core Questionnaire & Occupational Job Module Form and Instruction
Core Questionnaire & Occupational Job Module Form and Instruction
Core Questionnaire & Occupational Job Module Form and Instruction
Consent Form Form and Instruction
Consent Form Form and Instruction
Screener and Core Questionnaire Form and Instruction
Screener and Core Questionnaire Form and Instruction
Screener and Core Questionnaire Form and Instruction
Screener and Core Questionnaire Form and Instruction
Screener and Core Questionnaire Form and Instruction
Screener and Core Questionnaire Form and Instruction
Interviewer Administrative Forms (Attachment 9) Form and Instruction
Pathologist Administrative Form (Attachment 8) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction
Patient Screener, Core & Occupational Exposure Questionnaires_AsiaLymph (Attachments 3, 4 & 5) Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201510-0925-005 Revision of a currently approved collection 2015-10-30 Approved with change
201209-0925-002 Extension without change of a currently approved collection 2012-09-17 Approved without change
201203-0925-003 New collection (Request for a new OMB Control Number) 2012-03-10 Approved without change