MALE Participants Follow-Up Questionnaire - Module A

Persistence of Ebola Virus in Body Fluids of Ebola Virus Disease Survivors in Sierra Leone

OMB: 0920-1064

IC ID: 216620

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MALE Participants Follow-Up Questionnaire - Module A
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Follow-Up Questionnaire Att6_Follow-upQuestionnaire.docx None No   Fillable Fileable

Health Public Health Monitoring

 

175 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 2,100 0 2,100 0 0 0
Annual IC Time Burden (Hours) 525 0 525 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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