OMB control number

Persistence of Ebola Virus in Body Fluids of Ebola Virus Disease Survivors in Sierra Leone

OMB 0920-1064 · HHS/CDC.

OMB 0920-1064

Latest Forms, Documents, and Supporting Material

Document Name
Laboratory Results Form Form
FEMALE Participants Follow-Up Questionnaire - Module B Form and Instruction
FEMALE Participants Survivor Questionnaire - Module B Form and Instruction
FEMALE Participants Follow-Up Questionnaire - Module A Form and Instruction
FEMALE Participants Survivor Questionnaire - Module A Form and Instruction
MALE Participants Follow-Up Questionnaire - Module A Form and Instruction
MALE Participants Survivor Questionnaire - Module A Form and Instruction
PILOT Participants Follow-Up Questionnaire Form and Instruction
PILOT Participants Survivor Questionnaire Form and Instruction
Study Intake Form Form
20150518 SupptngStmntB-BodyFluidsSL_clean.docx Supporting Statement B
20150518 SupptngStmntA-BodyFluidsSL_clean.docx Supporting Statement A
OMBEmerRqustMemo EBOVPersist 20150518.pdf Supplementary Document
Att8_CounsellingScript.docx Supplementary Document
Att4_ParticipantStudyIDCard.pptx Supplementary Document
Att3_ConsentFormModuleB.docx Supplementary Document
Att2_ConsentFormPilotModuleA.docx Supplementary Document
AppndxC Sierra-Leone-Minimum-Wage.pdf Supplementary Document
AppndxB HmnSubjcts Revw-Apprvls.docx Supplementary Document
AppndxA 42 USC 241 PH Service Act Section 301.pdf Supplementary Document
Laboratory Results Form Form
FEMALE Participants Follow-Up Questionnaire - Module B Form and Instruction
FEMALE Participants Survivor Questionnaire - Module B Form and Instruction
FEMALE Participants Follow-Up Questionnaire - Module A Form and Instruction
FEMALE Participants Survivor Questionnaire - Module A Form and Instruction
MALE Participants Follow-Up Questionnaire - Module A Form and Instruction
MALE Participants Survivor Questionnaire - Module A Form and Instruction
PILOT Participants Follow-Up Questionnaire Form and Instruction
PILOT Participants Survivor Questionnaire Form and Instruction
Study Intake Form Form

All Historical Document Collections

201505-0920-002

Approved without change

New collection (Request for a new OMB Control Number)

2015-05-19