View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Perfluorinated Compound Biological Sampling in the Vicinity of Morgan, Lawrence, and Limestone Counties, Alabama 15AUQ
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA NA No   Paper Only

Health Consumer Health and Safety

09-19-0001 Records of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances  53 FR 30702

155 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 465 0 465 0 0 0
Annual IC Time Burden (Hours) 93 0 93 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Adult Consent Form for Blood and Urine PFC Testing and Questionnaire (>18 years of age) 08/05/2015
Adult Consent Form for Storage of Blood Sample for Use in Future Research (> 18 years of age) 08/05/2015
Children's Assent Form for Blood and Urine PFC Testing and Questionnaire (12 - <18 years of age) 08/05/2015
Children's Assent Form for Storage of Blood Sample for Use in Future Research (12 - < 18 years of age) 08/05/2015
Parental Permission Form for Blood and Urine PFC Testing and Questionnaire for Children (12 - < 18 years of age) Participating in Investigation 08/05/2015
Parental Permission Form for Storage of Blood Sample for Use in Future Research for Children (12 - <18 years of age) Participating in Investigation 08/05/2015
GenIC Submission Form 08/05/2015
Research Determination 08/05/2015
Sample Results Letter 08/05/2015
Example of Prior Exposure Investigation Final Report 08/05/2015
IRB Approval of CDC Protocol #6718 08/05/2015
Supporting Statement A 08/06/2015
Supporting Statement B 08/06/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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