Early Syphilis Cases (Section 2)

Enhanced STD Surveillance Network

OMB: 0920-1072

IC ID: 232376

Documents and Forms
Information Collection (IC) Details

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Early Syphilis Cases (Section 2) 0920-1072
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1072 Early Syphilis Cases (Section 2) Att 8_InterviewTemplate_GC_syphilis.pdf NA No   Fillable Fileable

Health Public Health Monitoring

 

406 0
   
Individuals or Households
 
   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 406 0 406 0 0 0
Annual IC Time Burden (Hours) 68 0 68 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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