Gonnorhea Case Surveillance

Enhanced STD Surveillance Network

OMB: 0920-1072

IC ID: 214282

Documents and Forms
Information Collection (IC) Details

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Gonnorhea Case Surveillance
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction none Case Surveillance by Health Department Manager Att 3C RoutineCase SurveillanceDataElements.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

10 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 120 0 120 0 0 0
Annual IC Time Burden (Hours) 1,920 0 1,920 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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