Multistate outbreak of coccidioidomycosis (Valley fever) in U.S. students and adults who traveled to Tijuana area, Mexico

Emergency Epidemic Investigation Data Collections - Expedited Reviews (Y3Q4)

OMB: 0920-1011

IC ID: 232840

Information Collection (IC) Details

View Information Collection (IC)

Multistate outbreak of coccidioidomycosis (Valley fever) in U.S. students and adults who traveled to Tijuana area, Mexico 0920-1011-18
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1011 Questionnaire - Valley Fever Appendix1_Questionnaire REVISED.doc NA No   Paper Only

Health Illness Prevention

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

130 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 130 0 0 0 0 130
Annual IC Time Burden (Hours) 43 0 0 0 0 43
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Letter of Invitation Investigation request - Valley fever - PRA application.pdf 08/28/2018
Burden Request Memo - Email 0920-1011 GenIC Request 2018002-XXX Valley Fever_Multi.msg 08/28/2018
0920-1011 GenIC Request 2018002-XXX Valley Fever_Multi.docx 08/28/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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