Daily Sympton Check

2019 Novel Coronavirus Airport Entry Questionnaires

OMB: 0920-1287

IC ID: 239872

Documents and Forms
Document Name
Document Type
Other-Recorded
Information Collection (IC) Details

View Information Collection (IC)

Daily Sympton Check 0920-20HF
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Recorded Daily Symptom Check.docx No   Fillable Fileable

Health Public Health Monitoring

 

10,000 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 280,000 0 0 0 0 280,000
Annual IC Time Burden (Hours) 23,333 0 0 0 0 23,333
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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