Reporting Severe Adverse Events (Hospitalization or Death) Associated with Treatment of Latent Tuberculosis Infection (LTBI) - Med Clerk

National Surveillance for Severe Adverse Events Associated with Treatment of Latent Tuberculosis Infection

OMB: 0920-0773

IC ID: 213550

Information Collection (IC) Details

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Reporting Severe Adverse Events (Hospitalization or Death) Associated with Treatment of Latent Tuberculosis Infection (LTBI) - Med Clerk
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form n/a Reporting Severe Adverse Events Associated with Treatment of Latent Tuberculosis Investion (LTBI) - Med Clerk Att4 Adverse Events LTBI NSSAE Medical Clerk 052017.docx No   Paper Only

Health Health Care Services

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

10 0
   
State, Local, and Tribal Governments
 
   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 10 0 10 0 0 0
Annual IC Time Burden (Hours) 10 0 10 0 0 0
Annual IC Cost Burden (Dollars) 182 0 182 0 0 0

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