71.21(c) Gastrointestinal Illness Report - 24 and 4 hours before arrival (MIDRS)

Maritime Illness Database and Reporting System (MIDRS)

OMB: 0920-1260

IC ID: 235047

Information Collection (IC) Details

View Information Collection (IC)

71.21(c) Gastrointestinal Illness Report - 24 and 4 hours before arrival (MIDRS)
 
No Removed
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Gastrointestinal Illness (GI) Template Att5a.MIDRSTemplate.txt NA Yes Yes Fillable Fileable
Form and Instruction NA MIDRS Template - screenshot Att8.MIDRSscreenshot.docx NA Yes Yes Fillable Fileable

Health Public Health Monitoring

 

250 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   95 %

  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 0 0 -2,500 0 0 2,500
Annual IC Time Burden (Hours) 0 0 -125 0 0 125
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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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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