2014013-XXX_Resp Illness UAC_Multi

Emergency Epidemic Investigation Data Collections - Expedited Reviews

OMB: 0920-1011

IC ID: 212348

Documents and Forms
Document Name
Document Type
Other-WORD
Other-WORD
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

2014013-XXX_Resp Illness UAC_Multi 14AOP
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Appendix 1 - Case Investigation Form.docx No   Fillable Printable
Other-WORD Appendix 2 - Medical Record Form.docx No   Fillable Printable

Health Public Health Monitoring

 

550 0
   
Private Sector Not-for-profit institutions
 
   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 550 0 0 0 0 550
Annual IC Time Burden (Hours) 275 0 0 0 0 275
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CDC Epi Aid Request FW CDC Epi Aid request received from ORR.msg 07/15/2014
0920-1011 URGENT Request Email 0920-1011 URGENT GenIC Request Resp Illness UAC_Multi.msg 07/15/2014
2-14013-XXX Res Illness UAC Multi 2014013-XXX_Resp Illness_UAC shelters.docx 07/16/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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