Clinical Inquiries Database

CDC Emergency Operations Center Zika Related Clinical Inquiries and Surveillance

OMB: 0920-1101

IC ID: 220149

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Clinical Inquiries Database
 
No Modified
 
Mandatory
 

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

Health Public Health Monitoring

09-20-0136 - Epidemiological Studies and Surveillance of Disease Problems  57 FR 62812

800 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 800 0 0 0 0 800
Annual IC Time Burden (Hours) 200 0 0 0 0 200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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