OMB control number

Assessment to Estimate the Effect of Community-Wide Vector Control Initiatives on Zika Virus Transmission in Puerto Rico, 2016

OMB 0920-1137 · HHS/CDC.

OMB 0920-1137

Latest Forms, Documents, and Supporting Material

Document Name
Refusal Demographics Form Form and Instruction
Individual specimen collection of blood, urine, and saliva Form
Individual Questionnaire Form and Instruction
Household Questionnaire Form and Instruction
0920-1137 change request.docx Justification for No Material/Nonsubstantive Change
Revised SSB Vector Control Initiatives_PR 12SEP2016.docx Supporting Statement B
Emergency Zika SSA - Vector Control Initiatives in PR_OMB 09 21 2016_RMB_FINAL.docx Supporting Statement A
Att I - Household Tracking Form.docx Supplementary Document
Att F - Assent for Children aged 5-14 SPANISH.docx Supplementary Document
Att F - Assent for Children aged 5-14.docx Supplementary Document
Att E - Adult Consent Form SPANISH.docx Supplementary Document
Att E - Adult Consent Form.docx Supplementary Document
Att D - Household and Individual Consent Form SPANISH (002).docx Supplementary Document
Att D - Household and Individual Consent Form.docx Supplementary Document
Att C - 6901 CDC IRB Approval Memo_New-Expedited 8 2 16.docx Supplementary Document
Att B - 60-Day FRN.docx Supplementary Document
Emergency Review Request Memo - Signed.pdf Supplementary Document
Refusal Demographics Form Form and Instruction
Individual specimen collection of blood, urine, and saliva Form
Individual Questionnaire Form and Instruction
Household Questionnaire Form and Instruction

All Historical Document Collections

201609-0920-018 Approved without change	No material or nonsubstantive change to a currently approved collection	2016-09-27
201608-0920-013 Approved with change	New collection (Request for a new OMB Control Number)	2016-09-13