Cyclosporiasis National Hypothesis Generating Questionnaire

Use of the Cyclosporiasis National Hypothesis Generating Questionnaire (CNHGQ) During Investigations of Foodborne Disease Clusters and Outbreaks

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1198 can be found here:

Documents and Forms

Document Name Document Type
Cyclosporiasis National Hypothesis Generating Questionnaire Form and Instruction
Cyclosporiasis National Hypothesis Generating Questionna Att D_CNHGQ 2020 - Epi Info Survey.pdf Form and Instruction
Cyclosporiasis National Hypothesis Generating Questionna Att E_CNHGQ 2020 - PDF fillable.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Cyclosporiasis National Hypothesis Generating Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Cyclosporiasis National Hypothesis Generating Questionnaire (CNHGQ) (electronic submission)	Att D_CNHGQ 2020 - Epi Info Survey.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Cyclosporiasis National Hypothesis Generating Questionnaire (CNHGQ) (fax submission)	Att E_CNHGQ 2020 - PDF fillable.pdf		No		Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,500	1,500	1,000
Annual IC Time Burden (Hours)	1,875	1,108	767
Annual IC Cost Burden (Dollars)	46,838	46,838	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.