Household Surveillance patients Form 1a Screening and enrollment log

United States and Global Human Influenza Surveillance in at-Risk Settings (NIAID)

OMB: 0925-0737

IC ID: 218286

Information Collection (IC) Details

View Information Collection (IC)

Household Surveillance patients Form 1a Screening and enrollment log
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 18 Attachment 2 Representative Informed Consent Form ATTACHMENT 2 - Representative Informed Consent Form.docx No   Fillable Fileable

Health Health Care Services

 

500 0
   
Individuals or Households
 
   0 %

  Requested 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 500 0 500 0 0 0
Annual IC Time Burden (Hours) 83 0 83 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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