EDN TB Follow-up Worksheet

US Tuberculosis Follow-up Worksheet for Newly Admitted Persons with Overseas Tuberculosis Classifications

OMB: 0920-1238

IC ID: 231229

Information Collection (IC) Details

View Information Collection (IC)

EDN TB Follow-up Worksheet
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-1238 The EDN Tuberculosis Follow-up Worksheet for Newly Arrived Persons with Overseas Tuberculosis Classifications Att 3_2021 EDN TB Follow-Up Worksheet_FINAL.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

Alien Tuberculosis Follow-up Program  51 FR 42462

1,548 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested 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 4,644 0 -21,756 0 26,400 0
Annual IC Time Burden (Hours) 2,322 0 -10,878 0 13,200 0
Annual IC Cost Burden (Dollars) 86,796 0 -406,620 0 493,416 0

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