Evaluation of CDC Service Provided to Public Health Labs to Rapidly Identify Multidrug-Resistant Isolates of TB

Surveys of State, Tribal, Local and Territorial (STLT) Governmental Health Agencies

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
Evaluation of CDC Service Provided to Public Health Labs to Rapidly Identify Multidrug-Resistant Isolates of TB Form
Evaluation of Detection of Drug Resistance Testing Servi ATTACHMENT C Survey Instrument-word version.docx Form
Drug Susceptability Test Results ATTACHMENT E. Data Collection Instrument-word version.docx Form
ATTACHMENT D. Survey Instrument-Web Shot.pdf Screen shots of Evaluation Instrument IC Document
ATTACHMENT F. Data Collection Form-Web shot.pdf Screen shots of Susceptability Instrument IC Document
MDDR Supporting Statement A - Draft 3 .docx Supporting Statement A IC Document
MDDR Supporting Statement B-Draft 3.docx Supporting Statement B IC Document
ATTACHMENT G. Public Health Laboratories and Isolates.docx Att G - PH Labs and Isolates IC Document
ATTACHMENT H Advance Survey Notification Email.docx Att H - Advance survey notification IC Document
ATTACHMENT I. Survey Notification Email.docx Att I - Survey notification email IC Document
ATTACHMENT J. Reminders (Email and Telephone).docx Att J - Reminders IC Document
ATTACHMENT A. A Report of Expert Consultations on Rapid Molecular Testing to Detect Drug Resistant Tuberculosis in the United States.docx ATTACHMENT A IC Document

Information Collection (IC) Details

IC Title:	Evaluation of CDC Service Provided to Public Health Labs to Rapidly Identify Multidrug-Resistant Isolates of TB	Agency IC Tracking Number:

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	none	Evaluation of Detection of Drug Resistance Testing Service	ATTACHMENT C Survey Instrument-word version.docx		Yes	Yes	Fillable Fileable
Form	none	Drug Susceptability Test Results	ATTACHMENT E. Data Collection Instrument-word version.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 43	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 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	344	0	0	0	0	0
Annual IC Time Burden (Hours)	61	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Screen shots of Evaluation Instrument	ATTACHMENT D. Survey Instrument-Web Shot.pdf	01/09/2012
Screen shots of Susceptability Instrument	ATTACHMENT F. Data Collection Form-Web shot.pdf	01/09/2012
Supporting Statement A	MDDR Supporting Statement A - Draft 3 .docx	01/09/2012
Supporting Statement B	MDDR Supporting Statement B-Draft 3.docx	01/09/2012
Att G - PH Labs and Isolates	ATTACHMENT G. Public Health Laboratories and Isolates.docx	01/09/2012
Att H - Advance survey notification	ATTACHMENT H Advance Survey Notification Email.docx	01/09/2012
Att I - Survey notification email	ATTACHMENT I. Survey Notification Email.docx	01/09/2012
Att J - Reminders	ATTACHMENT J. Reminders (Email and Telephone).docx	01/09/2012
ATTACHMENT A	ATTACHMENT A. A Report of Expert Consultations on Rapid Molecular Testing to Detect Drug Resistant Tuberculosis in the United States.docx	01/09/2012

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