Consent for Linkage to Reportable Infectious Diseases Results

Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS)

OMB: 0920-0010

IC ID: 216974

Information Collection (IC) Details

View Information Collection (IC)

Consent for Linkage to Reportable Infectious Diseases Results
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Written Consent for Release of Reportable Infectious Diseases (English) AttL1_InfectionConsent.docx No   Paper Only
Form and Instruction n/a Written Consent for Release of Reportable Infectious Diseases (Spanish) AttL2_InfectionConsent_SPAN.docx No   Paper Only
Form and Instruction n/a Verbal Consent for Release of Reportable Infectious Diseases (English) AttN1_InfectionVerbalConsent.docx No   Paper Only
Form and Instruction n/a Verbal Consent for Release of Reportable Infectious Diseases (Spanish) AttN2_InfectionVerbalConsent_SPAN.docx No   Paper Only

Health Public Health Monitoring

Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

2,590 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 2,590 0 0 0 0 2,590
Annual IC Time Burden (Hours) 648 0 0 0 0 648
Annual IC Cost Burden (Dollars) 6,475 0 0 0 0 6,475

Title Document Date Uploaded
Thank You Letter for Infectious Diseases Reporting (English) AttM1_InfectionThankYouLtr.docx 08/26/2019
Thank You Letter for Infectious Diseases Reporting (Spanish) AttM2_InfectionThankYouLtr_SPAN.docx 08/26/2019
FAQ about Reportable Infectious Diseases (English) AttY1_Infection_FAQ.docx 08/26/2019
FAQ about Reportable Infectious Diseases (Spanish) AttY2_Infection_FAQ_SPAN.docx 08/26/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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