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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Adult Consent
Unchanged
1501
250
6079
Form
NA
Adult Consent
Adult Exposure Assessment Questionnaire
Unchanged
1501
751
18267
Form
NA
Adult Exposure Assessment
Child Assent
Modified
199
33
241
Form and Instruction
none
Assent for Minors
Community Event Evaluation Survey
Unchanged
815
68
1654
Form
NA
PFAS Exposure Assessment Community Event Evaluation
EA Participants (All Ages) - Biological Testing Tracking
Unchanged
1975
658
0
Form
NA
FAS EA Biological Testing Tracking Form
Environmental Sample Collection Form
Unchanged
75
38
457
Form
NA
Environmental Sampling Collection Form
Environmental Sampling Consent
Unchanged
75
13
176
Form
NA
Consent for Environmental Sampling
Exposure Questionnaire for Biological Testing - Child Completed
Unchanged
199
50
360
Form
NA
Exposure Assessment Child
Exposure Questionnaire for Biological Testing - Parent Proxy
Unchanged
275
69
1675
Form
NA
Exposure Assessment Child
Household Eligibility Screener
Unchanged
1345
112
2730
Form
NA
Household Eligibility Screener
Household Recruitment Script for Environmental Sampling
Unchanged
117
10
238
Form
NA
Household Recruitment Script for Environmental Sampling
Parental Permission
Unchanged
474
79
1152
Form
NA
Parental Permission Form
Total burden requested under this ICR:
8551
2131
33029
To view an IC, click on IC Title