Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
ALS Biorepository Collection Form- Saliva Unchanged 350 58 0 Form none ALS Biorepository Saliva Collection
ALS Biorepository Specimen Processing Unchanged 325 163 0 Form none Biorepository Specimen Processing
ALS Case Registration Unchanged 1500 250 0 Form none Case registration
ALS DIsease Progression Survey Unchanged 2250 188 0 Form none Disease Progression Survey
ALS Registry Research Application Unchanged 36 18 0 Form and Instruction n/a National Amyotrophic Lateral Sclerosis (ALS) Registry Research Application Form (rev. May 2021)
ALS Validation Questions Unchanged 1670 56 0 Form none Case validation questions
Annual Update for Projects Receiving Specimens or Data Unchanged 24 6 0 Form none Annual update for projects receiving specimens and/data
Essential Questionnaire Unchanged 750 75 0 Form and Instruction n/a Essential Questionnaire
Follow-up Questions - ALS-associated and Clinical Factors Unchanged 750 88 0 Form and Instruction n/a ALS-associated and Clinical Factors
Follow-up Questions - Demography Unchanged 750 25 0 Form and Instruction n/a Demography
Follow-up Questions - Environmental Factors Unchanged 750 288 0 Form and Instruction n/a Environmental Factors
Follow-up Questions - Lifestyle Information Unchanged 750 400 0 Form and Instruction n/a Lifestyle Information
Incentives Pilot Project Sign Up form – Only for Texas Registrants New 100 5 0 Form and Instruction n/a Incentive Project Sign Up Form
National Office Outreach Reporting Unchanged 24 8 0 Form none National Office Outreach Reporting
Outreach Reporting Form for Chapters and Districts Unchanged 1620 135 0 Form none Chapter/District Outreach Reporting
Total burden requested under this ICR: 11649 1763 0  
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