Pediatric Case Telephone Interview

Risk Factors for Community-Associated Clostridium difficile Infection through the Emerging Infections Program

OMB: 0920-1013

IC ID: 210432

Information Collection (IC) Details

View Information Collection (IC)

Pediatric Case Telephone Interview
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1013 Attachment G_Pediatric Interview Form CLEAN VERSION Rev Attachment G_Pediatric Interview Form CLEAN VERSION 6_6_14.docx Yes Yes Fillable Fileable

Health Immunization Management

 

78 0
   
Individuals or Households
 
   0 %

  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 78 0 0 0 0 78
Annual IC Time Burden (Hours) 39 0 0 0 0 39
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Rev Attachment G_Pediatric Interview Form 6_6_14 Rev Attachment G_Pediatric Interview Form 6_6_14.docx 06/30/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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