GenIC Advance Notification Template

Attachment G. CSOI GenIC Advance Notification Email Template

The purpose of the “GenIC Expedited Approval Request Notification” email is to give ICRO, HHS, and OMB advance notification that an expedited request for OMB approval (in 24-hours) for an Emergency Cruise Ship Outbreak Investigation (CSOI) will be received with justification. The team is in the planning stages and wants to alert OMB that an expedited request is forthcoming.

From: [CSOI Information Collection Request Liaison (ICRL)]
To: [CDC OMB Clearance Mailbox]; [Chief, CDC Information Collection Review Office]
Subject: Expedited Approval Request Notification for GenIC 0920-XXXX – Cruise Ship Outbreak Investigation

This is advance notification that NCEH/ATSDR will submit the following GenIC request for expedited approval to the CDC Information Collection Review Office (ICRO) within the next [insert] day(s). We request that ICRO provide HHS and the OMB Desk Officer this preliminary information as soon as possible.

INVESTIGATION LEAD:

Name:

Title:

Affiliation:

CDC/ATSDR SPONSORING PROGRAM: [insert]

NAME, TITLE, AND CONTACT INFORMATION OF PROGRAM CONTACT: [insert]

TITLE OF INFORMATION COLLECTION: [insert]

REQUESTED EFFECTIVE DATE:

Requested Approval Date: [insert]

DESCRIPTION OF THIS SPECIFIC COLLECTION:

1. Cruise ship, voyage number, and sail dates to be investigated:

[insert]

2. Location of the Investigation:

[insert]

3. Cruise Line in Need of Epidemiological Assistance/Name and Title of Public Health Point of Contact:

[insert]

4. Target Population:

[ ] Passengers

[ ] Crew members

[ ] Other [insert]

5. Duration of Data Collection will be 30 days or less.

Please advise if additional action is required.

[Signature Block]