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Biospecimen Collection
Stress and Cortisol Measurement for the National Childrens Study (NICHD)
OMB: 0925-0671
IC ID: 203352
OMB.report
HHS/NIH
OMB 0925-0671
ICR 201207-0925-002
IC 203352
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0671 can be found here:
2013-01-04 - New collection (Request for a new OMB Control Number)
Documents and Forms
Document Name
Document Type
Form 3.1
Biospecimen Collection
Form and Instruction
Attach 19. Saliva Collection Participants Manual.docx
Instruction
3.1 Saliva Specimen Log
Attach 21. Saliva Specimen Log.doc
Form and Instruction
Note-to-File - Burden for IC #3.docx
Note-to-File - Burden for IC #3
IC Document
Attach 14. Study Hair Collection Protocol.docx
Hair Collection Protocol
IC Document
Attach 15. Study Visit 1 Blood Requisition Form.docx
Visit 1 Blood Requisition Form
IC Document
Attach 16. Study Visit 2 Blood Requisition Form.docx
Visit 2 Blood Requisition Form
IC Document
Attach 17. Visit 1 Blood Processing Protocol.doc
Visit 1 Blood Processing Protocol
IC Document
Attach 18. Visit 2 Blood Processing Protocol.docx
Visit 2 Blood Processing Protocol
IC Document
Attach 20. Saliva Processing Protocol.docx
Saliva Processing Protocol
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Biospecimen Collection
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
3.1
Saliva Specimen Log
Attach 21. Saliva Specimen Log.doc
Yes
Yes
Fillable Printable
Instruction
Attach 19. Saliva Collection Participants Manual.docx
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Science and Innovation
Subfunction:
Scientific and Technological Research and Innovation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
700
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
24,500
0
24,500
0
0
0
Annual IC Time Burden (Hours)
2,438
0
2,438
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Note-to-File - Burden for IC #3
Note-to-File - Burden for IC #3.docx
07/17/2012
Hair Collection Protocol
Attach 14. Study Hair Collection Protocol.docx
07/17/2012
Visit 1 Blood Requisition Form
Attach 15. Study Visit 1 Blood Requisition Form.docx
07/17/2012
Visit 2 Blood Requisition Form
Attach 16. Study Visit 2 Blood Requisition Form.docx
07/17/2012
Visit 1 Blood Processing Protocol
Attach 17. Visit 1 Blood Processing Protocol.doc
07/17/2012
Visit 2 Blood Processing Protocol
Attach 18. Visit 2 Blood Processing Protocol.docx
07/17/2012
Saliva Processing Protocol
Attach 20. Saliva Processing Protocol.docx
07/17/2012
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.