AR Lab Network Alert and Monthly Data Report Form for Neisseria gonorrhoeae

[NCEZID] Public Health Laboratory Testing for Emerging Antibiotic Resistance and Fungal Threats

Documents and Forms

Document Name Document Type
Form Form 9 AR Lab Network Alert and Monthly Data Report Form for Neisseria gonorrhoeae Form and Instruction
Form 9 AR Lab Network Alert and Monthly Data Report Form for Ne Attachment 3i Form 9 AR Lab Network Alert and Monthly Data Report Form for Neisseria gonorrhoeae final.docx Form and Instruction
Form 9 AR Lab Network Alert and Monthly Data Report Form for Ne Attachment 3i Form 9 AR Lab Network Alert and Monthly Data Report Form for Neisseria gonorrhoeae final.docx Form and Instruction

Information Collection (IC) Details

IC Title:	AR Lab Network Alert and Monthly Data Report Form for Neisseria gonorrhoeae	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form 9	AR Lab Network Alert and Monthly Data Report Form for Neisseria gonorrhoeae	Attachment 3i Form 9 AR Lab Network Alert and Monthly Data Report Form for Neisseria gonorrhoeae final.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	672	672
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.