Ebola Exposure Questionnaire for Flight Crew

Contact investigation Outcome Reporting Forms

OMB: 0920-0900

IC ID: 215018

Information Collection (IC) Details

View Information Collection (IC)

Ebola Exposure Questionnaire for Flight Crew
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Ebola Exposure Questionnaire for Flight Crew Attachment Q ExposureQuestionnaire_FlightCrew.docx None Yes Yes Fillable Fileable

Health Public Health Monitoring

Quarantine- and Traveler-Related Activities  72 FR 7086

120 0
   
Individuals or Households
 
   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 240 0 0 0 0 240
Annual IC Time Burden (Hours) 80 0 0 0 0 80
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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