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Case Report Evaluations
[NCHHSTP] National HIV Surveillance System (NHSS)
OMB: 0920-0573
IC ID: 205248
OMB.report
HHS/CDC
OMB 0920-0573
ICR 202310-0920-007
IC 205248
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0573 can be found here:
2024-08-06 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Case Report Evaluations
Form and Instruction
Adult HIV Confidential Case Report Form
Att_3(a) Adult Case Report Form 2023 v17.pdf
Form and Instruction
Pediatric HIV Confidential Case Report Form
Att_3(b) Pediatric Case Report Form 2023 v18.pdf
Form and Instruction
Information Collection (IC) Details
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