Download:
pdf |
pdfOMB Number: 0925-0770
Expiration Date: 09/30/2024
PHS Inclusion Enrollment Report
1. * Inclusion Enrollment Report Title
2. * Using an Existing Dataset or Resource
3. * Enrollment Location Type
4. Enrollment Country(ies)
5. Enrollment Location(s)
6. Comments
Yes
Domestic
No
Foreign
Planned
Ethnic Categories
Racial Categories
Not Hispanic or Latino
Female
Hispanic or Latino
Male
Female
Total
Male
American Indian/
Alaska Native
0
0
0
0
0
Asian
0
0
0
0
0
Native Hawaiian or
Other Pacific Islander
0
0
0
0
0
Black or African
American
0
0
0
0
0
White
0
0
0
0
0
More than One Race
0
0
0
0
0
Total
0
0
0
0
0
Cumulative (Actual)
Ethnic Categories
Racial Categories
Not Hispanic or Latino
Female
Hispanic or Latino
Unknown/
Not
Reported
Male
Female
Unknown/
Not
Reported
Male
Total
Unknown/Not Reported Ethnicity
Female
Unknown/
Not
Reported
Male
American Indian/
Alaska Native
0
0
0
0
0
0
0
0
0
0
Asian
0
0
0
0
0
0
0
0
0
0
Native Hawaiian or
Other Pacific Islander
0
0
0
0
0
0
0
0
0
0
Black or African
American
0
0
0
0
0
0
0
0
0
0
White
0
0
0
0
0
0
0
0
0
0
More than One Race
0
0
0
0
0
0
0
0
0
0
Unknown or Not
Reported
0
0
0
0
0
0
0
0
0
0
Total
0
0
0
0
0
0
0
0
0
0
Report 1 of 1
Public reporting burden for this collection of information is estimated to average 1 hours per response, including the time for reviewing instructions, searching existing data sources,
gathering, and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to
respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA
(0925-0770). Do not return the completed form to this address.
| File Type | application/pdf |
| File Title | PHSInclusionEnrollmentReport-V1.0.pdf |
| Author | garstkv |
| File Modified | 2024-09-19 |
| File Created | 2024-09-19 |