Demographic/Clinical Data for Sites Conducting Core Surveillance

Gonococcal Isolate Surveillance Project

OMB: 0920-0307

IC ID: 6747

Information Collection (IC) Details

View Information Collection (IC)

Demographic/Clinical Data for Sites Conducting Core Surveillance
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form n/a Core Demographic/Clinical Data Att 3a1_core clinic data.pptx Yes Yes Fillable Fileable
Instruction Att 7_Data coding guide.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

09-20-0136: Epidemiologic Studies and Surveillance of Disease Problems. HHS/CDC”  57 FR 62812

20 0
   
State, Local, and Tribal Governments
 
   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 4,800 0 -2,400 0 0 7,200
Annual IC Time Burden (Hours) 880 0 -440 0 0 1,320
Annual IC Cost Burden (Dollars) 16,966 0 16,966 0 0 0

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.

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