Information Collection

[CSTLTS, NCIRD] Pediatric Hepatitis-Adenovirus Case Control Evaluation, United States, 2022 – 2023

IC 256747 under ICR 202011-0920-003 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0879 Pediatric Hepatitis - MEDICAL RECORD ABSTRACTION FORM [CSTLTS, NCIRD] Pediatric Hepatitis-Adenovirus Case Control Evaluation, United States, 2022 – 2023	Form
Form 0920-0879 Pediatric Hepatitis - Exposure Questionnaire [CSTLTS, NCIRD] Pediatric Hepatitis-Adenovirus Case Control Evaluation, United States, 2022 – 2023	Form
Form 0920-0879 Pediatric Hepatitis - Exposure Questionnaire (Spanish) [CSTLTS, NCIRD] Pediatric Hepatitis-Adenovirus Case Control Evaluation, United States, 2022 – 2023	Form
Form 0920-0879 Pediatric Hepatitis - Exposure Questionnaire CONTROL [CSTLTS, NCIRD] Pediatric Hepatitis-Adenovirus Case Control Evaluation, United States, 2022 – 2023	Form
Form 0920-0879 Pediatric Hepatitis - Exposure Questionnaire CONTROL (Spanish) [CSTLTS, NCIRD] Pediatric Hepatitis-Adenovirus Case Control Evaluation, United States, 2022 – 2023	Form

Record metadata
IC Title	[CSTLTS, NCIRD] Pediatric Hepatitis-Adenovirus Case Control Evaluation, United States, 2022 – 2023