OMB control number

ZEN Colombia Study - Zika in Pregnant Women and Children in Colombia

OMB 0920-1142 · HHS/CDC.

OMB 0920-1142

Latest Forms, Documents, and Supporting Material

Document Name
Adult Symptom Questionnaire Form
Male Partner Enrollment Questionnaire Form
Male Partner Eligibility Questionnaire Form
Infant Symptoms Questionnaire Form
Pregnant Women Follow-Up Questionnaire Form
Adult Symptom Questionnaire Form
Pregnant Women Enrollment Questionnaire Form
Pregnant Women Eligibility Questionnaire Form
60Day_FRN_ZEN.docx Supplementary Document
ZEN Colombia - Signed OMB memo.pdf Supplementary Document
Att_B9_Male Participant Informed Consent 09222016.docx Supplementary Document
Att_B7_Pregnant Woman Informed Consent 09222016.docx Supplementary Document
OMB_Part B_ZEN_09262016.docx Supporting Statement B
OMB_PartA_ZEN_10272016.docx Supporting Statement A
Att_D_Assurance of Confidentiality Zika Surveillance Final.doc Supplementary Document
Att_C_6921 New Site Restricted Approval.docx Supplementary Document
Att_A_Section 301 of Public Health Service Act (42 U.S.C. 241).docx Supplementary Document
Adult Symptom Questionnaire Form
Male Partner Enrollment Questionnaire Form
Male Partner Eligibility Questionnaire Form
Infant Symptoms Questionnaire Form
Pregnant Women Follow-Up Questionnaire Form
Adult Symptom Questionnaire Form
Pregnant Women Enrollment Questionnaire Form
Pregnant Women Eligibility Questionnaire Form

All Historical Document Collections

201610-0920-001

2016-10-27