Individual specimen collection of blood, urine, and saliva

Assessment to Estimate the Effect of Community-Wide Vector Control Initiatives on Zika Virus Transmission in Puerto Rico, 2016

OMB: 0920-1137

IC ID: 223493

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Form
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Information Collection (IC) Details

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Individual specimen collection of blood, urine, and saliva
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form NA Adult Consent Form - English Att E - Adult Consent Form.docx NA No   Paper Only
Form NA Adult Consent Form - Spanish Att E - Adult Consent Form SPANISH.docx NA No   Paper Only
Form NA Assent Children 5-14 - English Att F - Assent for Children aged 5-14.docx NA No   Paper Only
Form NA Assent Children 5-14 - Spanish Att F - Assent for Children aged 5-14 SPANISH.docx NA No   Paper Only

Health Public Health Monitoring

09-20-0113 Epidemic Investigation Case Records Systems Notice  51 FR 42466

500 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 500 0 0 0 0 500
Annual IC Time Burden (Hours) 83 0 0 0 0 83
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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