OMB control number

A Longitudinal Examination of Mental and Physical Health among Police Associated with COVID–19

OMB 0920-1350 · HHS/CDC.

OMB 0920-1350

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920- Att D18- Serological Sample Form
Form 0920- Att D17- Civil Unrest Form
Form 0920- Att D16- COVID19- Round 2 Form
Form 0920- Att D15- COVID- Round 1 Form
Form 0920- Att D14- Beck Hopelessness Form
Form 0920- Att D13- Beck Depression Form
Form 0920- Att D12- Pittsburgh Sleep Quality Index Form
Form 0920- Att D11- Beck Anxiety Form
Form 0920 Att D10- Connor-Davidson Resiliency Scale Form
Form 0920 Att D9- PTSD Form
Form 0920 Att D8- Fatigue Scale Form
Form 0920- Att D7- Maslach Burnout Form
Form 0920 Att D6- Org Support Form
Form 0920- Att D5_Brief Cope Form
Form 0920- Att D4- Centers for Epidemiologic Studies Depression Scale Form
Form 0920- Att H1_Eligibility Screening Form
Form 0920- Att D3- Spielberger Stress Survey Form
Form 0920 Att D2- Medical History Form
Form 0920 Att D1- Personal History Form
Change Request Memo 12OCT2021.docx Justification for No Material/Nonsubstantive Change
Appendix F2 NIOSH HSRB_non_exempt.pdf Supplementary Document
Appendix F1 UB IRB.docx Supplementary Document
Appendix E UB Consent Form.docx Supplementary Document
Appendix C Examination Components.docx Supplementary Document
Appendix B _60dy2121CG.FRN.pdf Supplementary Document
Appendix A.docx Supplementary Document
Statement B_revised 092921.docx Supporting Statement B
Statement A_revised 92921.docx Supporting Statement A
Att D19- Salivary Cortisol collection Other-
Att D18- Serological Sample Form
Att D17- Civil Unrest Form
Att D16- COVID19- Round 2 Form
Att D15- COVID- Round 1 Form
Att D14- Beck Hopelessness Form
Att D13- Beck Depression Form
Att D12- Pittsburgh Sleep Quality Index Form
Att D11- Beck Anxiety Form
Att D10- Connor-Davidson Resiliency Scale Form
Att D9- PTSD Form
Att D8- Fatigue Scale Form
Att D7- Maslach Burnout Form
Att D6- Org Support Form
Att D5_Brief Cope Form
Att D4- Centers for Epidemiologic Studies Depression Scale Form
Att H1_Eligibility Screening Form
Att H_Introduction Letter Other-word
Att G_Letter of Invitation Other-WORD
Att D3- Spielberger Stress Survey Form
Att D2- Medical History Form
Att D1- Personal History Form

All Historical Document Collections

202110-0920-005 Approved without change	No material or nonsubstantive change to a currently approved collection	2021-10-12
202106-0920-006 Approved with change	New collection (Request for a new OMB Control Number)	2021-07-29