Healthcare Worker-Ebola Virus Disease Exposure Risk Report (CDC/WHO)

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: 214670

Information Collection (IC) Details

View Information Collection (IC)

Healthcare Worker-Ebola Virus Disease Exposure Risk Report (CDC/WHO) 0920-1033-15LC
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1033 Att A HCW.EVD.expriskreport_WestAfrica Att A HCW.EVD.expriskreport_WestAfrica_20141025.pdf No   Fillable Printable

Health Public Health Monitoring

 

300 100
   
Private Sector Businesses or other for-profits
 
   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 300 0 300 0 0 0
Annual IC Time Burden (Hours) 150 0 150 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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