Acute Respiratory Infection and Influenza Surveillance Form

Information Collection on Cause-Specific Absenteeism in Schools

OMB: 0920-1039

IC ID: 212417

Information Collection (IC) Details

View Information Collection (IC)

Acute Respiratory Infection and Influenza Surveillance Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form NA Acute Respiratory Infection and Influenza Surveillance Form 28DEC2015 Orchards ari surveillance form revised 12 22 15_1-temte.docx NA Yes Yes Fillable Fileable

Health Public Health Monitoring

09-20-0160 Records of Subjects in Health Promotion and Education Studies, HHS/CDC.CHPE  51 FR 42484

1,500 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 6,000 0 0 0 0 6,000
Annual IC Time Burden (Hours) 3,000 0 0 0 0 3,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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