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Cruise Ship Physician - COVID-19 Case Investigation Worksheet (if necessary)
[NCEZID] Phased Approach to the Resumption of Cruise Ship Passenger Operations
OMB: 0920-1335
IC ID: 248855
OMB.report
HHS/CDC
OMB 0920-1335
ICR 202310-0920-011
IC 248855
( )
Documents and Forms
Document Name
Document Type
Form 0920-1335
Cruise Ship Physician - COVID-19 Case Investigation Worksheet (if necessary)
Form
0920-1335 COVID-19 Case Investigation worksheet
Case Investigation Worksheet_08062021.xlsx
Form
0920-1335 COVID-19 Case Investigation worksheet
Case Investigation Worksheet_08062021.xlsx
Form
0920-1335 Attachment K_Cruise COVID19 Case Investigation Worksheet
Attachment K_Cruise COVID19 Case Investigation Worksheet.xlsx
Form
0920-1335 Attachment K_Cruise COVID19 Case Investigation Worksheet
Attachment K_Cruise COVID19 Case Investigation Worksheet.xlsx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Cruise Ship Physician - COVID-19 Case Investigation Worksheet (if necessary)
Agency IC Tracking Number:
0920-1335
Is this a Common Form?
No
IC Status:
Unchanged
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
0920-1335
COVID-19 Case Investigation worksheet
Case Investigation Worksheet_08062021.xlsx
NA
Yes
Yes
Fillable Fileable
Form
0920-1335
Attachment K_Cruise COVID19 Case Investigation Worksheet
Attachment K_Cruise COVID19 Case Investigation Worksheet.xlsx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
104
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
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
104
0
0
0
0
104
Annual IC Time Burden (Hours)
52
0
0
0
0
52
Annual IC Cost Burden (Dollars)
0
0
0
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.