Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Michigan Biomonitoring Questionnaire New 200 180 0 Form none
Michigan Consent New 200 3 0 Form none
Michigan Scheduling Questionnaire New 250 29 0 Form none
Michigan Screener New 350 29 0 Form none
Minnesota Clinic Visit New 250 4 0 Form none
Minnesota Consent New 250 13 0 Form none
Minnesota Contact Information New 250 8 0 Form none
Minnesota Participant Questionnaire New 250 125 0 Form none
Minnesota Participation Record New 250 13 0 Form none
Minnesota Recruitment Script New 312 26 0 Form none
Minnesota Refusal Questions New 62 2 0 Form none
NY Burmese Consent New 50 1 0 Form none
NY Burmese Network Questions New 50 4 0 Form none
NY Burmese Questionnaire New 50 50 0 Form none
NY Burmese Screener New 92 8 0 Form none
New York Consent New 200 3 0 Form none
New York Mail-in Screener New 300 25 0 Form none
New York Non-responder Script New 500 42 0 Form none
New York On-line Screener New 450 38 0 Form none
New York Questionnaire New 200 100 0 Form none
New York Responder Script New 150 13 0 Form none
Total burden requested under this ICR: 4666 716 0  
To view an IC, click on IC Title