Initial Questionnaire for Case-Patients

Ebola Transmission Dynamics among Household Contacts in West Africa: a Public Health Response Evaluation in Western Area, Sierra Leone

OMB: 0920-1043

IC ID: 214715

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Initial Questionnaire for Case-Patients
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Initial Questionnaire for Case-Patients Att1 Init Questnnre Case-Patient 20150118.docx None Yes Yes Fillable Fileable

Disaster Management Emergency Response

09-20-0113 Epi Invest Case Records  51 FR 42466

119 0
   
Individuals or Households
 
   80 %

  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 119 0 119 0 0 0
Annual IC Time Burden (Hours) 40 0 40 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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