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Federal forms, ICRs, and supporting documents

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Undetermined risk of exposure for human-to-human spread of rabies to contact of case patient following mongoose-associated human rabies case, Puerto Rico, 2015.

IC 219193 under ICR 201604-0920-011 · OMB 0920-1011.

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

View Information Collection (IC)

Undetermined risk of exposure for human-to-human spread of rabies to contact of case patient following mongoose-associated human rabies case, Puerto Rico, 2015. 0920-1011-16GM
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Community Assessment Appendix_1a_Community Assessment.docx NA No   Paper Only
Form and Instruction NA Community Assessment - Spanish Appendix_1b_Community Assessment_Spanish.docx NA No   Paper Only
Form and Instruction NA Healthcare Worker Assessment Appendix_2a_Healthcare worker Assessment.docx NA No   Paper Only
Form and Instruction NA Healthcare Worker Assessment Appendix_2b_Healthcareworker Assessment_Spanish.docx NA No   Paper Only

Health Illness Prevention

Epidemic Investigation Case Records 09-20-0113  51 FR 42466

250 0
   
Individuals or Households
 
   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 250 0 0 0 0 250
Annual IC Time Burden (Hours) 50 0 0 0 0 50
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Letter of Invitation - Puerto Rico Invitation letter rabies PEP 2015.docx 12/07/2015
GenIC Request - Rabies PR 2015 2016005-007 Rabies_Puerto Rico.docx 12/07/2015
Burden Estimate - Email 0920-1011 Rabies_PR Burden Estimate.msg 12/07/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.