OMB control number

Zika Virus RNA Persistence in Pregnant Women and Congenitally Exposed Infants in Puerto Rico (ZIRP)

OMB 0920-1189 · HHS/CDC.

OMB 0920-1189

Latest Forms, Documents, and Supporting Material

Document Name
Infant Follow-Up Questionnaire Form and Instruction
Infant Enrollment and Delivery Questionnaire Form and Instruction
Pregnant Women Follow-Up Questionnaire Form and Instruction
Pregnant Women Symptom Questionnaire Form and Instruction
Pregnant Women Enrollment Questionnaire Form and Instruction
Pregnant Women Screening Form Form and Instruction
OMB_Part B_ZIRP_full_v1_clean.docx Supporting Statement B
OMB_Part A_ZIRP_full_v1_clean.docx Supporting Statement A
Att E1- 7005 IRB Submission Approval.docx Supplementary Document
Att D3 - Agreement to abide by data restrictions.docx Supplementary Document
Att D2 - FTE Non-disclosure agreement.docx Supplementary Document
Att D1 - Assurance of Confidentiality.docx Supplementary Document
deb lubar signed memo.pdf Supplementary Document
Att B - 60-day notice.pdf Supplementary Document
Att A - Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document
Infant Follow-Up Questionnaire Form and Instruction
Infant Enrollment and Delivery Questionnaire Form and Instruction
Pregnant Women Follow-Up Questionnaire Form and Instruction
Pregnant Women Symptom Questionnaire Form and Instruction
Pregnant Women Enrollment Questionnaire Form and Instruction
Pregnant Women Screening Form Form and Instruction

All Historical Document Collections

201706-0920-003

2017-07-10