Follow-up and Treatment of Contacts to Tuberculosis Case Form - Electronic (Data Clerks and Program Managers)

Aggregate Reports for Tuberculosis Program Evaluation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0457 can be found here:

Documents and Forms

Document Name Document Type
Follow-up and Treatment of Contacts to Tuberculosis Case Form - Electronic (Data Clerks and Program Managers) Form and Instruction
Follow-up and Treatment of Contacts to Tuberculosis Case Att 3a_Follow up and Treatment for Contacts to TB CasesForm.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Follow-up and Treatment of Contacts to Tuberculosis Case Form - Electronic (Data Clerks and Program Managers)	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 and Instruction	None	Follow-up and Treatment of Contacts to Tuberculosis Case Form	Att 3a_Follow up and Treatment for Contacts to TB CasesForm.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	100	50	50
Annual IC Time Burden (Hours)	50	25	25
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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