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Federal forms, ICRs, and supporting documents

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Gastrointestinal Illness Reports 24 and 4 hours before Arrival (VSP) Title 71.21. (c)

IC 202073 under ICR 201304-0920-012 · OMB 0920-0134.

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Document Type
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Form
IC Document
Information Collection (IC) Details

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Gastrointestinal Illness Reports 24 and 4 hours before Arrival (VSP) Title 71.21. (c)
 
No Modified
 
Mandatory
 
42 CFR Subpart C  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 2 Maritime Illness and Death Reporting System--Gastrointestinal Illness Report Attachment 6a 71.21c Gastrointestinal illnesses reports MIDRS screenshot.pdf Yes No Fillable Fileable

Health Immunization Management

Quarantine and Traveler-Related Activities, Including Records for Tracing, Investigation and Notification under 42 CFR Parts 70 and 71  72 FR 70867

17,000 0
   
Private Sector Businesses or other for-profits
 
   100 %

  Requested 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 17,000 0 0 0 0 17,000
Annual IC Time Burden (Hours) 850 0 0 0 0 850
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment 5 Reportable Medical Conditions Attachment 5 Reportable Medical Conditions.docx 04/23/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.