Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Adult Consent Modified 1501 250 6079 Form none Adult consent
Adult Exposure Assessment Questionnaire Modified 1501 751 18267 Form none Adult-Child Exposure Assessment Questionnaire
Child Assent Modified 199 33 241 Form and Instruction none Child assent
Community Event Evaluation Survey Modified 815 68 1654 Form none Exposure assessment community event survey
EA Participants (All Ages) - Biological Testing Tracking Modified 1975 658 0 Form none EA participants biological testing tracking
Environmental Sample Collection Form Modified 75 38 457 Form none Environmental sample collection form
Environmental Sampling Consent Modified 75 13 176 Form none Consent for environmental sampling
Exposure Questionnaire for Biological Testing - Child Completed Modified 199 50 360 Form none Child exposure assessment
Exposure Questionnaire for Biological Testing - Parent Proxy Modified 275 69 1675 Form NA Exposure Assessment Child
Household Eligibility Screener Modified 1345 112 2730 Form none Household eligibility screener
Household Recruitment Script for Environmental Sampling Modified 117 10 238 Form none Household recruitment script for environmental sampling
Parental Permission Modified 474 79 1152 Form none Parental permission
Total burden requested under this ICR: 8551 2131 33029  
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