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Offspring and Omni Group 1 Cohorts
The Framingham Study (NHLBI)
OMB: 0925-0216
IC ID: 183649
OMB.report
HHS/NIH
OMB 0925-0216
ICR 201309-0925-008
IC 183649
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0216 can be found here:
2016-04-26 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 6a
Offspring and Omni Group 1 Cohorts
Form and Instruction
6a Records Request Form
Attachment 6a- Records Request.pdf
Form and Instruction
6b Informant Contact Form
Attachment 6b- Informant Contact.pdf
Form and Instruction
7a Initial Telephone Contact Form
Attachment 7a- Telephone Contact.pdf
Form and Instruction
A3 Food Frequency Form
Attachment 3- FFQ, Offspring and Omni Grp 1.pdf
Form and Instruction
1a Clinical Exam Form
Attachment 1a - Clinic Exam, Offspring & Omni Grp 1.pdf
Form and Instruction
1b Home Visit/Nursing Home Visit Form
Attachment 1b- Home Visit, Offspring & Omni Grp 1.pdf
Form and Instruction
A14 Consent Forms
Attachment 14- Annual Newsletter.pdf
Form and Instruction
A4 Health Status Update Form
Attachment 4 - Medical Hx Update Form.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Offspring and Omni Group 1 Cohorts
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
6a
Records Request Form
Attachment 6a- Records Request.pdf
Yes
Yes
Paper Only
Form and Instruction
6b
Informant Contact Form
Attachment 6b- Informant Contact.pdf
Yes
Yes
Paper Only
Form and Instruction
7a
Initial Telephone Contact Form
Attachment 7a- Telephone Contact.pdf
Yes
Yes
Paper Only
Form and Instruction
A3
Food Frequency Form
Attachment 3- FFQ, Offspring and Omni Grp 1.pdf
Yes
Yes
Paper Only
Form and Instruction
1a
Clinical Exam Form
Attachment 1a - Clinic Exam, Offspring & Omni Grp 1.pdf
No
No
Paper Only
Form and Instruction
1b
Home Visit/Nursing Home Visit Form
Attachment 1b- Home Visit, Offspring & Omni Grp 1.pdf
No
No
Paper Only
Form and Instruction
A14
Consent Forms
Attachment 14- Annual Newsletter.pdf
Yes
Yes
Paper Only
Form and Instruction
A4
Health Status Update Form
Attachment 4 - Medical Hx Update Form.pdf
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,813
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
4,813
0
2,353
0
0
2,460
Annual IC Time Burden (Hours)
2,235
0
586
0
0
1,649
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.