Att 3_Proposed Changes_FINAL

Summary of Proposed Changes in the ICR for

The Gonococcal Isolate Surveillance Project (GISP)

OMB # 0920-0307

Attachment 3

Summary of Revisions

The revision to the ICR consists of removing 4 variables from the approved Form 1: Demographic and Clinical Data (Attachment 3a). The variables to be removed have not proven useful in the past. Removal of these variables will not increase or decrease the burden.

Use the table below to identify the attachments affected by the change, where on the attachment the change occurs, and what the change is.

Table 1. Proposed Modifications

Location in Documents	Modifications
Attachment 3a: (first full row of Form 1)	Removed monthly clinic total of gonorrhea episodes diagnosed and corresponding date
Attachment 3a: (columns 14-16)	Removed ‘Date of birth’
Attachment 3a: (column 20)	Removed ‘Reason for visit’
Attachment 3a: (column 23)	Removed ‘Zipcode’

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