Sexually Transmitted Disease (STD) Morbidity Surveillance : State, City and county, and Territorial health departments

Sexually Transmitted Disease (STD) Morbidity Surveillance

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0819 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Sexually Transmitted Disease (STD) Morbidity Surveillance : State, City and county, and Territorial health departments Form and Instruction
1 Data Elements Revised STD_XXXX_SuppStmnt_ATT3 072209.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Sexually Transmitted Disease (STD) Morbidity Surveillance : State, City and county, and Territorial health departments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Data Elements	Revised STD_XXXX_SuppStmnt_ATT3 072209.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 57	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 98 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,964	2,964
Annual IC Time Burden (Hours)	988	988
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.