(drss) Concession/partner Employee Illness Report

National Park Service (NPS) Office of Public Health (OPH) Disease Reporting and Surveillance Forms

Documents and Forms

Document Name Document Type
Form NPS Form 10-685 (DRSS) CONCESSION/PARTNER EMPLOYEE ILLNESS REPORT Form
NPS Form 10-685 DISEASE REPORTING AND SURVEILLANCE SYSTEM (DRSS) CONCESS NPS 10-685 DRSS CONCESSION EMPLOYEE ILLNESS REPORT. (V3.2.2023).pdf Form
NPS Form 10-685 DISEASE REPORTING AND SURVEILLANCE SYSTEM (DRSS) CONCESS NPS 10-685 DRSS CONCESSION EMPLOYEE ILLNESS REPORT. (V3.2.2023).pdf Form

Information Collection (IC) Details

IC Title:	(DRSS) CONCESSION/PARTNER EMPLOYEE ILLNESS REPORT	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NPS Form 10-685	DISEASE REPORTING AND SURVEILLANCE SYSTEM (DRSS) CONCESSION/PARTNER EMPLOYEE ILLNESS REPORT	NPS 10-685 DRSS CONCESSION EMPLOYEE ILLNESS REPORT. (V3.2.2023).pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 500

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	500	200	300
Annual IC Time Burden (Hours)	83	33	50
Annual IC Cost Burden (Dollars)	0	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.