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Exposure Investigation - Blood Lead Levels in Iola, Kansas 17EL
 
New
 
Voluntary
 

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

Health Public Health Monitoring

09-19-0001 - Records of Persons Exposed or Potentially Exposed to Hazardous or Toxic Substances  59 FR 67085

300 0
   
Individuals or Households
 
   100 %

  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 500 0 500 0 0 0
Annual IC Time Burden (Hours) 250 0 250 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Parental Permission Form for Venous Blood Sampling for Lead and Questionnaire - Children Less Than 18 Years of Age 11/14/2016
Assent Form for Blood Lead and Questionnaire Youth 6-17 Years of Age 11/14/2016
Consent Form for Venous Blood Lead Testing and Questionnaire - Pregnant Women and Women of Childbearing Age 11/14/2016
Research Determination 11/14/2016
Sample Results Letter - Younger than 18 Years of Age 11/14/2016
Sample Results Letter - Pregnant Woman or Woman of Child Bearing Age 11/14/2016
Blood Lead Levels - Inserts for Letters 11/14/2016
Fact Sheets 11/14/2016
Exposure Investigation Report - Perfluorochemical Serum Sampling Decatur, AL 11/14/2016
Supporting Statement B 11/14/2016
Advance Notification of Urgent Exposure Investigationo 11/14/2016
Supportinig Statement A 11/21/2016
Exposure Investigation Protocol Blood Lead Levels - Iola, KS 11/21/2016
GenI Submission Form 11/21/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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