Information Collection

[NCEZID] 2022 Ebola Traveler Follow Up Evaluation

IC 256626 under ICR 202301-0920-006 · OMB 0920-1376.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
[NCEZID] 2022 Ebola Traveler Follow Up Evaluation	Form and Instruction
Risk Assessment and Post-Arrival Monitoring Outcome Reporting Process for Persons with Travel History from Uganda [NCEZID] 2022 Ebola Traveler Follow Up Evaluation	Form and Instruction
Form 0920-1376 Risk Assessment and Post-Arrival Monitoring Outcome REDCap Reporting Process [NCEZID] 2022 Ebola Traveler Follow Up Evaluation	Form
Risk Assessment and Post-Arrival Monitoring Outcome Repo Attachment C-Risk Assessment and Post-Arrival Monitoring Outcome REDCap Reporting .docx	Form and Instruction
Risk Assessment and Post-Arrival Monitoring Outcome Repo Attachment C-Risk Assessment and Post-Arrival Monitoring Outcome REDCap Reporting .docx	Form and Instruction
0920-1376 Risk Assessment and Post-Arrival Monitoring Outcome REDC Attachment A-Risk Assessment and Post-Arrival Monitoring Outcome REDCap Reporting_11.17.2022_FINAL.docx	Form
0920-1376 Risk Assessment and Post-Arrival Monitoring Outcome REDC Attachment A-Risk Assessment and Post-Arrival Monitoring Outcome REDCap Reporting_11.17.2022_FINAL.docx	Form

IC Title:

Agency IC Tracking Number:

0920-1376-23BE

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

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	NA			NA	Yes	Yes	Fillable Fileable
Form	0920-1376				Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 350

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	18,200	18,200
Annual IC Time Burden (Hours)	4,550	4,550
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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