US/WHO International Clinical Network Ebola Virus Disease Clinical Data Collection Tool

Data Supplement for Ebola Virus Disease Patients Treated Outside of West Africa

OMB: 0920-1069

IC ID: 216874

Information Collection (IC) Details

View Information Collection (IC)

US/WHO International Clinical Network Ebola Virus Disease Clinical Data Collection Tool
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form None US/WHO Clinical Network EVD Data Collection Tool AppndxC US-WHO ClinNetworkEVDDataCollTool 20150604.xlsx None Yes Yes Fillable Fileable

Disaster Management Emergency Response

Epidemic Investigation Case Records  51 FR 42466

21 18
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 42 0 42 0 0 0
Annual IC Time Burden (Hours) 32 0 32 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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