Information Collection Request
ICR 201111-0923-002 · OMB 0923-0043 · Public filing
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0923-0043 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 ALS Medical Record Verification Form |
Form | Modified | Available |
| ALS Case Reporting Form |
Form | Modified | Available |
 CDC Protocol #5923_CLEAN copy_ State-Metro ALS Surveillance Protocol.doc |
Supplementary Document | Uploaded 2011-11-14 | Available |
| CDC Protocol#5923_ Amendment approval.doc |
Supplementary Document | Uploaded 2011-11-14 | Available |
| ICR#0923-0043_Justification for unsubstantive change_11.2.2011.doc |
Justification for No Material/Nonsubstantive Change | Uploaded 2011-11-14 | Available |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 196100 |  Line Listing |
Instruction | Modified | |
| 196099 | Training for Reporting |
Instruction | Modified | |
| 196098 | ALS Medical Record Verification Form |
Form | Modified | |
| 196097 | ALS Case Reporting Form |
Form | Modified |
ICR Details
| OMB Control No | 0923-0043 |
|---|