Ebola Virus Disease Case Contact Questionnaire

2014 Emergency Response to Ebola in West Africa: Data Collection for Assisting Foreign and International Entities to Conduct Public Health Activities

OMB: 0920-1033

IC ID: 213620

Information Collection (IC) Details

View Information Collection (IC)

Ebola Virus Disease Case Contact Questionnaire 0920-15CN
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-15CN Attachment L_Ebola Virus Disease Case Contact Questionnaire Attachment L_Ebola Virus Disease Case Contact Questionnaire.doc Yes No Fillable Printable

Health Illness Prevention

Ebola Emergency Investigation Case Records System Notice  51 FR 42166

50 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 50 0 50 0 0 0
Annual IC Time Burden (Hours) 4 0 4 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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