Dengue Case Investigation

National Disease Surveillance Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0009 can be found here:

Documents and Forms

Document Name Document Type
Form none assigned Dengue Case Investigation Form
none assigned Dengue DEN CASE Form Eng 2004.pdf Form
none assigned Dengue-Spanish Dengue Case Investigation Report Spa.pdf Form
DCIF_English_Color_proposed_jun2009.ppt Proposed Dengue Case Investigation Report form IC Document

Information Collection (IC) Details

IC Title:	Dengue Case Investigation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 assigned	Dengue	DEN CASE Form Eng 2004.pdf		Yes	Yes	Printable Only
Form	none assigned	Dengue-Spanish	Dengue Case Investigation Report Spa.pdf		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems 09-20-0136	FR Citation: 57 FR 62812

Number of Respondents: 55	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	10,010	10,010
Annual IC Time Burden (Hours)	2,503	2,503
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Proposed Dengue Case Investigation Report form	DCIF_English_Color_proposed_jun2009.ppt	06/08/2009

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