Zika Outcomes and Development of Infants and Children (ZODIAC) Investigation

OMB 0920-1194

Latest Forms, Documents, and Supporting Material

Document Name
Blood Draw Form and Instruction
Vision Exam Form and Instruction
Neurological Exam - Hammersmith Infant Neurologic Exam / Evaluation of Cerebral Palsy Form and Instruction
Physical Health Exam Form and Instruction
Growth Exam Form and Instruction
Parenting Stress Index - Short Form Form and Instruction
Patient Health Questionniare - 9 Form and Instruction
Ages and Stages Questionnaire - Social / Emotional Form and Instruction
Ages and Stages Questionniare - 3rd Edition Form and Instruction
Seizure Screen Form and Instruction
Parent Questionnaire Form and Instruction
Medical Record Abstraction Form Form and Instruction
Recruitment and Participation Log Form
SSB - ZODIAC Emergency ICR_submitted 7_14_17.docx Supporting Statement B
SSA - ZODIAC Emergency ICR_submitted_7-14-17.docx Supporting Statement A
Emergency Review Request Memo - ZODIAC Investigation_signed 7-14-17.pdf Supplementary Document
Att. 12 - ZODIAC Non-Research Determination.docx Supplementary Document
Att. 11 - Public Health Handsouts for Families with Babies with Microcephaly.docx Supplementary Document
Att. 10 - List of ZODIAC Measures.docx Supplementary Document
Att. 6 - Consent and Assent Forms.docx Supplementary Document
Att. 5 - Public Health Handouts.docx Supplementary Document
Att. 4 - Introductory Script.docx Supplementary Document
Att. 1 - Authorizing Legislation.docx Supplementary Document
Blood Draw Form and Instruction
Vision Exam Form and Instruction
Neurological Exam - Hammersmith Infant Neurologic Exam / Evaluation of Cerebral Palsy Form and Instruction
Physical Health Exam Form and Instruction
Growth Exam Form and Instruction
Parenting Stress Index - Short Form Form and Instruction
Patient Health Questionniare - 9 Form and Instruction
Ages and Stages Questionnaire - Social / Emotional Form and Instruction
Ages and Stages Questionniare - 3rd Edition Form and Instruction
Seizure Screen Form and Instruction
Parent Questionnaire Form and Instruction
Medical Record Abstraction Form Form and Instruction
Recruitment and Participation Log Form