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EDN TB Follow-up Worksheet

IC 231229 under ICR 202310-0920-005 · OMB 0920-1238.

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EDN TB Follow-up Worksheet 0920-1238
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-1238 The EDN Tuberculosis Follow-Up Worksheet for Newly-Arrived Persons with Overseas Tuberculosis Classifications Att 3 2021 EDN TB Follow-Up Worksheet.pdf Yes Yes Fillable Fileable
Form 0920-1238 EDN Tuberculosis Follow-Up Worksheet for Newly-Arrived Persons with Overseas Tuberculosis Classifications - 12 OCT2023 2023 EDN TB Follow-Up Worksheet_Revised_Clean.docx N/A Yes Yes Fillable Fileable

Health Public Health Monitoring

Alien Tuberculosis Follow-up Program  51 FR 42462

2,262 0
   
State, Local, and Tribal Governments
 
   100 %

  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 9,048 0 0 0 0 9,048
Annual IC Time Burden (Hours) 4,524 0 0 0 0 4,524
Annual IC Cost Burden (Dollars) 169,107 0 0 0 0 169,107

Title Document Date Uploaded
Revisions Made to The EDN Tuberculosis Follow-Up Worksheet Att 3a_Detailed Chart of Revisions on the 2021 EDN TB Follow-Up Worksheet.docx 05/17/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.