GONOCOCCAL PELVIC INFLAMMATORY DISEASE SUMMARY REPORT

ICR 198207-0920-003

OMB: 0920-0121

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
110734 Migrated
ICR Details
0920-0121 198207-0920-003
Historical Active
HHS/CDC
GONOCOCCAL PELVIC INFLAMMATORY DISEASE SUMMARY REPORT
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 10/22/1982
Retrieve Notice of Action (NOA) 07/29/1982
  Inventory as of this Action Requested Previously Approved
10/31/1984 10/31/1984
720 0 0
2,160 0 0
0 0 0

GONOCOCCAL PELVIC INFLAMMATORY DISEASE (GPID) IS THE MOST COMMON SERIO COMPLICATION OF SEXUALLY TRANSMITTED INFECTIONS CAUSED BY NEISSERIA GONORRHOEAE IN WOMEN. THIS SUMMARY REPORTING SYSTEM FOR GPID WILL BE USED AS AN INTEGRAL COMPONENT OF THE NATIONAL EFFORT TO CONTROL AND MAINTAIN SURVEILLANCE OF GPID.

None
None


No

1
IC Title Form No. Form Name
GONOCOCCAL PELVIC INFLAMMATORY DISEASE SUMMARY REPORT CDC 73.14

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 720 0 0 720 0 0
Annual Time Burden (Hours) 2,160 0 0 2,160 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/29/1982


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