Drss Tour Vehicle Passenger 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 10-686 DRSS TOUR VEHICLE PASSENGER ILLNESS REPORT Form
NPS Form 10-686 DISEASE REPORTING AND SURVEILLANCE SYSTEM (DRSS) TOUR VE NPS 10-686 DRSS TOUR VEHICLE PASSENGER ILLNESS REPORT.ICCO Review.pdf Form
NPS Form 10-686 DISEASE REPORTING AND SURVEILLANCE SYSTEM (DRSS) TOUR VE NPS 10-686 DRSS TOUR VEHICLE PASSENGER ILLNESS REPORT.ICCO Review.pdf Form

Information Collection (IC) Details

IC Title:	DRSS TOUR VEHICLE PASSENGER 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 10-686	DISEASE REPORTING AND SURVEILLANCE SYSTEM (DRSS) TOUR VEHICLE PASSENGER ILLNESS REPORT	NPS 10-686 DRSS TOUR VEHICLE PASSENGER ILLNESS REPORT.ICCO Review.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 90

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	150	60	90
Annual IC Time Burden (Hours)	38	15	23
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.