BEEA CATI Screening Script for RSG Eligibility, REG Eligibility or AMG Eligibility

Agricultural Health Study: A Prospective Cohort Study of Cancer and Other Diseases Among Men and Women in Agriculture

Documents and Forms

Document Name Document Type
Form 4 BEEA CATI Screening Script for RSG Eligibility, REG Eligibility or AMG Eligibility Form and Instruction
4 Attachment 20-1 BEEA CATI Script Random Select Group Attachment 20-1_BEEA_CATI Script_Random Select Group_highlighted.pdf Form and Instruction
5 Attachment 20-2 BEEA CATI Script Recent Exposed Group Attachment 20-2_BEEA_CATI Script_Recent Exposed Group_highlighted.pdf Form and Instruction
6 Attachment 20-3 BEEA CATI Script Recently Exposed +Air M Attachment 20-3_BEEA_CATI Script_Recently Exposed + Air Monitoring Group_highlighted.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	BEEA CATI Screening Script for RSG Eligibility, REG Eligibility or AMG Eligibility	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	Available Electronically?	Electronic Capability
Form and Instruction	4	Attachment 20-1 BEEA CATI Script Random Select Group	Attachment 20-1_BEEA_CATI Script_Random Select Group_highlighted.pdf	No	Paper Only
Form and Instruction	5	Attachment 20-2 BEEA CATI Script Recent Exposed Group	Attachment 20-2_BEEA_CATI Script_Recent Exposed Group_highlighted.pdf	No	Paper Only
Form and Instruction	6	Attachment 20-3 BEEA CATI Script Recently Exposed +Air Monitoring Group	Attachment 20-3_BEEA_CATI Script_Recently Exposed + Air Monitoring Group_highlighted.pdf	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: 09-25-0200 Clinical, Basic and Population-based Research Studies	FR Citation: 67 FR 60776

Number of Respondents: 480	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Farms

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	480	480
Annual IC Time Burden (Hours)	160	160
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.