Information Collection

Clinical Inquiries Database

IC 220149 under ICR 201602-0920-005 · OMB 0920-1101.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1101 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Clinical Inquiries Database	Form and Instruction
2016 Zika Virus Inquiry Log Att. I -- Domestic Zika Clinical Inquiries Database.pdf	Form and Instruction

IC Title:

Clinical Inquiries Database

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	2016 Zika Virus Inquiry Log	Att. I -- Domestic Zika Clinical Inquiries Database.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0136 - Epidemiological Studies and Surveillance of Disease Problems

FR Citation: 57 FR 62812

Number of Respondents: 800

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	800	800
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.