Burden Memo
EEI GenIC 0920-1011 - E-cigarette associated Pulmonary Illness_Multi-State
The burden estimate for ROCIS is:
Data Collection Instrument Name |
Type of Respondent |
Data Collection Mode |
No. Respondents (A) |
No. Responses per Respondent (B) |
Burden per Response in Minutes (C) |
Total Burden in Hours (A x B x C)/60* |
|
|
|
|
|
|
|
Appendix 1. National Case Report Form – Standard Version |
Health Department Staff or Clinician |
Abstraction form |
750 |
1 |
60 |
750 |
Appendix 2. National Case Report Form – Abbreviated Version |
Health Department Staff or Clinician |
Abstraction form |
750 |
1 |
30 |
375 |
Appendix 3. Specimen Manifest Form |
Public Health Laboratory Staff |
Paper-and-pencil form |
20 |
5 |
10 |
17 |
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Zirger, Jeffrey (CDC/DDPHSS/OS/OSI) |
| File Modified | 0000-00-00 |
| File Created | 2021-01-15 |