Attachment 15 - Cumulative Inclusion Enrollment Report.pdf
PDF 944 KB Posted
- Attached to
- 2023 NIAID Omnibus Broad Agency Announcement
- Solicitation number
- HHS-NIH-NIAID-BAA2023-1
View the file
Other files
Show all 17
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Cumulative Inclusion Enrollment Report
This report format should NOT be used for collecting data from study participants.
Study Title:
Comments:
Ethnic Categories
Racial Categories Not Hispanic or Latino Hispanic or Latino Unknown/Not Reported Ethnicity Total
Female Male Unknown/
Not Reported
Female Male Unknown/
Not Reported
Female Male Unknown/
Not Reported
American Indian/ Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Black or African American
White
More Than One Race
Unknown or Not Reported
Total
PHS 398 / PHS 2590 (Rev. 08/12 Approved Through 8/31/2015) OMB No. 0925-0001/0002 Page Cumulative Inclusion Enrollment Report
| StudyTitle: |
| Comments: |
| PageNumber: |
| F_NotLatino_Indian: |
| M_NotLatino_Indian: |
| U_NotLatino_Indian: |
| F_Latino_Indian: |
| M_Latino_Indian: |
| U_Latino_Indian: |
| Total_Indian: 0 |
| F_NotLatino_Asian: |
| M_NotLatino_Asian: |
| U_NotLatino_Asian: |
| F_Latino_Asian: |
| M_Latino_Asian: |
| U_Latino_Asian: |
| Total_Asian: 0 |
| F_NotLatino_Pacific: |
| M_NotLatino_Pacific: |
| U_NotLatino_Pacific: |
| F_Latino_Pacific: |
| M_Latino_Pacific: |
| U_Latino_Pacific: |
| Total_Pacific: 0 |
| F_NotLatino_Black: |
| M_NotLatino_Black: |
| U_NotLatino_Black: |
| F_Latino_Black: |
| M_Latino_Black: |
| U_Latino_Black: |
| Total_Black: 0 |
| F_NotLatino_White: |
| M_NotLatino_White: |
| U_NotLatino_White: |
| F_Latino_White: |
| M_Latino_White: |
| U_Latino_White: |
| Total_White: 0 |
| F_NotLatinoMultiRace: |
| M_NotLatinoMultiRace: |
| U_NotLatinoMultiRace: |
| F_LatinoMultiRace: |
| M_LatinoMultiRace: |
| U_LatinoMultiRace: |
| Total_MultiRace: 0 |
| F_LatinoUnknwnRace: |
| M_LatinoUnknwnRace: |
| U_LatinoUnknwnRace: |
| Total_MaleNotLatino: 0 |
| Total_FemaleNotLatino: 0 |
| Total_FemaleLatino: 0 |
| Total_MaleLatino: 0 |
| F_NotLatinoUnknwnRace: |
| M_NotLatinoUnknwnRace: |
| U_NotLatinoUnknwnRace: |
| FUknwnEthnicityRace: |
| MUknwnEthnicityRace: |
| UUknwnEthnicityRace: |
| FUknwnEthnicityIndian: |
| FUknwnEthnicityAsian: |
| FUknwnEthnicityPacific: |
| FUknwnEthnicityWhite: |
| FUknwnEthnicityMultiRace: |
| MUknwnEthnicityIndian: |
| MUknwnEthnicityAsian: |
| MUknwnEthnicityPacific: |
| FUknwnEthnicityBlack: |
| MUknwnEthnicityWhite: |
| MUknwnEthnicityMultiRace: |
| UUknwnEthnicityIndian: |
| UUknwnEthnicityAsian: |
| UUknwnEthnicityPacific: |
| UUknwnEthnicityBlack: |
| UUknwnEthnicityWhite: |
| UUknwnEthnicityMultiRace: |
| Total_UnknownSexEthnicity: 0 |
| Total_UnknownRace: 0 |
| Total_UnknownSexNotLatino: 0 |
| Total_UnknownSexLatino: 0 |
| Total_FemaleUnknownEthnicity: 0 |
| Total_MaleUnknownEthnicity: 0 |
| MUknwnEthnicityBlack: |
| Total_AllParticipants: 0 |
File details come from the government source that posted it. Updated .