Emergency Epidemic Investigations--Individual Households and Physcians

Emergency Epidemic Investigations

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0008 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Emergency Epidemic Investigations--Individual Households and Physcians Form
1 Emergency Epidemic Investigations--Individuals, Househol ATTACHMENT D - Emergency Epi Investigation forms (Template).doc Form

Information Collection (IC) Details

IC Title:	Emergency Epidemic Investigations--Individual Households and Physcians	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	1	Emergency Epidemic Investigations--Individuals, Households, Physcians, etc.	ATTACHMENT D - Emergency Epi Investigation forms (Template).doc		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemic Investigation Case Records HHS/CDC/NCID	FR Citation: 51 FR 42466

Number of Respondents: 15,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	15,000	15,000
Annual IC Time Burden (Hours)	3,750	3,750
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.