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Information Collection

Zika Pilot Study Data Collection Form

IC 231808 under ICR 201809-0906-001 · OMB 0906-0036.

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

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Zika Pilot Study Data Collection Form
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 Zika Data Elements Instrument.docx 20180511 Zika Data Elements Instrument CLEAN.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

20 0
   
Private Sector Not-for-profit institutions
 
   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 1,160 0 0 0 0 1,160
Annual IC Time Burden (Hours) 589 0 0 0 0 589
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.