Information Collection

Emergency Epidemic Investigations--Individual Households and Physcians

IC 6601 under ICR 200912-0920-004 · OMB 0920-0008.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.