Att N Novel Influenza A Virus Infection Contact Tracing Form

National Disease Surveillance Program - II. Disease Summaries

OMB: 0920-0004

IC ID: 199042

Information Collection (IC) Details

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Att N Novel Influenza A Virus Infection Contact Tracing Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form None Novel Influenza A Virus Infection Contact Tracing Form Att N_Novel Influenza A Virus Infection Contact Tracing Form.pdf Yes Yes Fillable Printable

Health Public Health Monitoring

 

57 0
   
State, Local, and Tribal Governments
 
   100 %

  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 57 0 0 0 0 57
Annual IC Time Burden (Hours) 29 0 0 0 0 29
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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