September 16, 2015
Currently Approved:
10 |
Intended embryo source (select all that apply): Patient embryos Donor embryos [IF ONLY DONOR EMBRYOS SELECTED, SKIP TO #12] |
10A |
If intent is to use FRESH EMBRYOS, specify intended oocyte source. Select all that apply: Patient oocytes Fresh oocytes Frozen oocytes Donor oocytes Fresh oocytes Frozen oocytes
If intent is to use FROZEN EMBRYOS, specify intended oocyte source. Select all that apply: Patient oocytes Fresh oocytes Frozen oocytes Donor oocytes Fresh oocytes Frozen oocytes Unknown (select only if oocyte source is unknown) |
Proposed:
10 |
Intended embryo source (select all that apply): [IF ONLY DONOR EMBRYOS SELECTED, SKIP TO #12] Patient embryos Donor embryos Fresh embryos Frozen embryos
|
10A |
If intent is to use FRESH EMBRYOS, specify intended oocyte source. Select all that apply: Fresh patient oocytes Frozen patient oocytes
Fresh donor oocytes Frozen donor oocytes
If intent is to use FROZEN EMBRYOS, specify intended oocyte source. Select all that apply: Fresh patient oocytes Frozen patient oocytes
Fresh donor oocytes Frozen donor oocytes Unknown (select only if oocyte source is unknown) |
Currently Approved:
14 |
Embryo source (select all that apply): Patient embryos Donor embryos [IF ONLY DONOR EMBRYOS SELECTED, SKIP TO #15] |
14A |
If FRESH EMBRYOS were used, specify intended oocyte source. Select all that apply: Patient oocytes Fresh oocytes Frozen oocytes Donor oocytes Fresh oocytes Frozen oocytes
If FROZEN EMBRYOS were used, specify intended oocyte source. Select all that apply: Patient oocytes Fresh oocytes Frozen oocytes Donor oocytes Fresh oocytes Frozen oocytes Unknown (select only if oocyte source is unknown) |
Proposed:
14 |
Embryo source (select all that apply): [IF ONLY DONOR EMBRYOS SELECTED, SKIP TO #15] Patient embryos Donor embryos Fresh embryos Frozen embryos
|
14A |
If FRESH EMBRYOS were used, specify intended oocyte source. Select all that apply: Fresh patient oocytes Frozen patient oocytes
Fresh donor oocytes Frozen donor oocytes
If FROZEN EMBRYOS were used, specify intended oocyte source. Select all that apply: Fresh patient oocytes Frozen patient oocytes
Fresh donor oocytes Frozen donor oocytes Unknown (select only if oocyte source is unknown) |
Additional question:
24A |
[IF OOCYTE SOURCE = PATIENT AND DONOR, ANSWER THIS QUESTION] Youngest oocyte source Patient [SKIP TO Q25] Donor [CONTINUE TO Q24B) |
A revised version of Attachment C1b_v2 (Proposed) Future NASS screens for 2016 is attached to the Change Request.
There is no change to the estimated burden per response, however, the improved formatting collects accurate information and effectively reduces the number of response boxes to check. CDC plans to begin administering the revised instruments in 2016. OMB approval is requested, effective immediately.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | DeBruyn, Lemyra (CDC/ONDIEH/NCCDPHP) |
File Modified | 0000-00-00 |
File Created | 2021-01-22 |