Ebola Exposure Questionnaire for Cleaning Crew

Emergency Submission to Supplement OMB Control Number 0920-0900 in Context of Contact Investigations Associated with Ebola and Travel

OMB: 0920-1032

IC ID: 213969

Information Collection (IC) Details

View Information Collection (IC)

Ebola Exposure Questionnaire for Cleaning Crew
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form None Ebola Exposure Questionnaire for Cleaning Crew Attachment D ExposureQuestionnaire_CleaningCrew.docx None No   Paper Only

Health Public Health Monitoring

 

600 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 1,200 0 1,200 0 0 0
Annual IC Time Burden (Hours) 400 0 400 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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