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Evaluating the Association between Serum Concentrations of Per- and Polyfluoroalkyl Substances (PFAS) and Symptoms and Diagnoses of Selected Acute Viral Illnesses

Attachments List

OMB: 0923-0064

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Evaluating the Association between Serum Concentrations of Per- and Polyfluoroalkyl Substances (PFAS) and Symptoms and Diagnoses of Selected Acute Viral Illnesses



List of Attachments and Protocol Appendices



Attachment A. Authorizing Legislation

Attachment B. 60-day Federal Register Notice

Attachment B1. Public Comments and Agency Responses

Attachment C. Privacy Impact Assessment (PIA) Form

Attachment D. IRB Approval

Attachment E. Manual of Procedures

Attachment F. Template for Data Use Agreement

Attachment G. Data Management Plan



Protocol (body) and Appendices

Appendix A – Initial questionnaire adults

Appendix B – Initial questionnaire children

Appendix C – Follow-up questionnaire adults, paper

Appendix C1 – Follow-up questionnaire adults, REDCap

Appendix D – Follow-up questionnaire children, paper

Appendix D1 – Follow-up questionnaire children, REDCap

Appendix E – Symptom Diary

Appendix F – Immune Studies Summaries

Appendix G – Invitation Letter

Appendix G1 – Cover-Letter for PEATT Participants

Appendix G2 – Recruitment Communications Materials

Appendix H – Adult Consent Form

Appendix I – Parental Permission form

Appendix J – Children assent forms

Appendix K – Privacy Act Statement

Appendix L – Non-response message




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