MPEP for M. TB and non-tuberculous Mycobacteria Drug Susceptibility Testing Results Worksheet

Centers for Disease Control and Prevention Performance Evaluation Program for Mycobacterium Tuberculosis/Non-tuberculosis Mycobacteria Drug Susceptibility Testing Program

OMB: 0920-0600

IC ID: 46480

Information Collection (IC) Details

View Information Collection (IC)

MPEP for M. TB and non-tuberculous Mycobacteria Drug Susceptibility Testing Results Worksheet
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Results Worksheet 0920-0600 Attachment 4c Gen Instruction and Results Worksheet (2).doc Yes Yes Fillable Fileable
Form none Revised Results Worksheet NewFormTB Questions.1.doc Yes Yes Fillable Fileable
Form none Results Worksheet - revised 5/2011 Result Booklet 2011_0504.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

132 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 264 0 0 0 0 264
Annual IC Time Burden (Hours) 132 0 0 0 0 132
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Case history example 0920-0600 Attachment 4d NTM Case History Form.doc 12/16/2009
Pre-shipment letter 0920-0600 Attachment 4a Pre-Shipment Letter.doc 12/16/2009
Shipment password letter 0920-0600 Attachment 4b Shipment and Password Letter.doc 12/16/2009
Reminder email 0920-0600 Attachment 4ei Reminder Email.doc 12/16/2009
Reminder telephone script 0920-0600 Attachment 4eii Phone Script.doc 12/16/2009
Preliminary report 0920-0600 Attachment 4f Prelim Results Letter.doc 12/16/2009
Aggregate report letter 0920-0600 Attachment 4g Aggregate Results Letter.doc 12/16/2009
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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