Coordination with TB Treating Physician/Foreign Health Authority in New Country

Information Collection for Tuberculosis Data from Referring Entities to CureTB

OMB: 0920-1186

IC ID: 226739

Information Collection (IC) Details

View Information Collection (IC)

Coordination with TB Treating Physician/Foreign Health Authority in New Country
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Telephone Script for Clinician/Foreign Health Authority Referral Follow-up Att. E CureTB Clinician_PHD Follow-up script.docx No   Paper Only

Health Public Health Monitoring

09-20-0171, Quarantine- and Traveler-related Activities Including Records for Contact Tracing Investigation and Notification under 42 CFR Parts 70 and 71  72 FR 70867

870 0
   
State, Local, and Tribal Governments
 
   50 %

  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 2,610 0 0 0 0 2,610
Annual IC Time Burden (Hours) 435 0 0 0 0 435
Annual IC Cost Burden (Dollars) 10,279 0 0 0 0 10,279

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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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