Ebola Entry Screening Risk Assessment (Ill Traveler Interview)

Quarantine Station Illness Response Forms: Airline, Maritime, and Land/Border Crossing

OMB: 0920-0821

IC ID: 214908

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Ebola Entry Screening Risk Assessment (Ill Traveler Interview)
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Ebola Entry Screening Risk Assessment Form - English Attachment G1 CDC Form Ebola Risk Assessment 05FEB2015.docx None No   Paper Only
Form and Instruction None Ebola Entry Screening Risk Assessment Form - French Attachment G2 CDC Form Ebola Risk Assessment Trans Guide French.docx None No   Paper Only
Form and Instruction None Ebola Entry Screening Risk Assessment Form - Arabic Attachment G3 CDC Form Ebola Risk Assessment Trans Guide Arabic.doc None No   Paper Only

Health Public Health Monitoring

Quarantine- and Traveler-Related Activities, Including Records for Contact Tracing Investigation  72 FR 7086

100 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 0 0 -100 0 0 100
Annual IC Time Burden (Hours) 0 0 -25 0 0 25
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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