Information Collection

Perinatal HIV Exposure Reporting (PHER)

IC 46035 under ICR 202008-0920-010 · OMB 0920-0573.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0573 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Perinatal HIV Exposure Reporting (PHER)	Form and Instruction
Perinatal HIV Exposure Reporting Form Att 3d_Perinatal HIV Exposure Reporting Form 2019_v1_OMB_rev18Jun19.pdf	Form and Instruction
Att 4b_PEDIATRIC HIV AND PERINATAL EXPOSURE CONFIDENTIAL CASE REPORT FORM_TG..pdf Technical Guidance: Pediatric HIV Case Reporting and Perinatal HIV Exposure Reporting	IC Document

IC Title:

Perinatal HIV Exposure Reporting (PHER)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Perinatal HIV Exposure Reporting Form	Att 3d_Perinatal HIV Exposure Reporting Form 2019_v1_OMB_rev18Jun19.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Epidemiologic Studies and Surveillance of Disease Problems HHS/CDC

FR Citation: 57 FR 61812

Number of Respondents: 16

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	3,152	3,152
Annual IC Time Burden (Hours)	1,576	1,576
Annual IC Cost Burden (Dollars)	42,552	42,552

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Technical Guidance: Pediatric HIV Case Reporting and Perinatal HIV Exposure Reporting	Att 4b_PEDIATRIC HIV AND PERINATAL EXPOSURE CONFIDENTIAL CASE REPORT FORM_TG..pdf	06/26/2019

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