[NIOSH] Noise Exposures and Hearing Loss in the Oil and Gas Extraction Industry

ICR 202502-0920-009

OMB: 0920-1416

Federal Form Document

Forms and Documents

Document Name	Status
Form 0920-22DI Audiometry Testing Form and Instruction	Unchanged
Form 0920-22DI Informed Consent Form and Instruction	Unchanged
Form 0920-22DI Noise and Hearing Questionnaire Form and Instruction	Modified
Change Request form EO 14168_BK.docx Justification for No Material/Nonsubstantive Change	2025-02-26
Attachment B_60_day FRN.pdf Supplementary Document	2023-08-30
NIOSH IRB Conditional Approval Report.docx Supplementary Document	2023-08-23
Attachment J_Audiometric exam results notification letter.docx Supplementary Document	2023-08-23
Attachment I_Exposure results notification letter.docx Supplementary Document	2023-08-23
Attachment H_Sample forms.docx Supplementary Document	2023-08-23
Attachment E_Fact sheet.docx Supplementary Document	2023-08-23
Attachment D_Introductory recruitment letter.docx Supplementary Document	2023-08-23
Attachment A - Authorizing Legislation.docx Supplementary Document	2023-08-23
Supporting Statement B_04-12-23.docx Supporting Statement B	2023-08-23
Supporting Statement A_04-12-23.docx Supporting Statement A	2023-08-30

IC Document Collections

IC ID	Document Title	Status
261727	Audiometry Testing Form and Instruction	Unchanged
261725	Informed Consent Form and Instruction	Unchanged
261723	Noise and Hearing Questionnaire Form and Instruction	Modified