Information Collection Request

ICR 202402-0920-008 · OMB 0920-1385 · Public filing

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-1385 can be found here:

2025-01-16 - Revision of a currently approved collection

Forms and Documents

Forms and supporting documents for this ICR
Document	Type	Status	Availability
Antifungal-resistant dermatophytosis case report form rev	Form and Instruction	New	Available
Antifungal-resistant dermatophytosis case report form	Form and Instruction	New	Available
Antifungal-resistant dermatophytosis case report form	Form and Instruction	New	Repair queued
Candida auris Case Report Form rev	Form and Instruction	New	Available
Candida auris Case Report Form	Form and Instruction	New	Available
Candida auris Case Report Form	Form and Instruction	New	Repair queued
Blastomycosis Case Report Form rev	Form and Instruction	New	Available
Blastomycosis Case Report Form	Form and Instruction	New	Available
Blastomycosis Case Report Form	Form and Instruction	New	Repair queued
Histoplasmosis Case Report Form rev	Form and Instruction	New	Available
Histoplasmosis Case Report Form	Form and Instruction	New	Available
Histoplasmosis Case Report Form	Form and Instruction	New	Repair queued
Coccidioidomycosis Case Report Form rev	Form and Instruction	New	Available
Coccidioidomycosis Case Report Form	Form and Instruction	New	Available
Coccidioidomycosis Case Report Form	Form and Instruction	New	Repair queued
Triazole-resistant Aspergillus fumigatus Case Report Form rev	Form and Instruction	Modified	Available
Triazole-resistant Aspergillus fumigatus Case Report Form	Form and Instruction	Modified	Available
Triazole-resistant Aspergillus fumigatus Case Report Form	Form and Instruction	Modified	Repair queued
Att. 5- Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2024-03-14	Repair queued
Att 4- Human Subjects Determination.pdf	Supplementary Document	Uploaded 2024-03-14	Repair queued
Att 2-Published 60-day FRN.pdf	Supplementary Document	Uploaded 2024-03-14	Repair queued
Att 1 Section 301 of the Public Health Service Act (42 USC 241).pdf	Supplementary Document	Uploaded 2024-03-14	Repair queued
Supporting Statement B.docx	Supporting Statement B	Uploaded 2024-03-14	Repair queued
Supporting Statement A_final.docx	Supporting Statement A	Uploaded 2024-03-14	Available

IC Document Collections

ICR Details

Record metadata
OMB Control No	0920-1385

IC ID	Collection	Type	Status	Form
266002	Antifungal-resistant dermatophytosis case report form	Form and Instruction	New	Antifungal-resistant dermatophytosis case report form rev
266002	Antifungal-resistant dermatophytosis case report form	Form and Instruction	New	Antifungal-resistant dermatophytosis case report form
266002	Antifungal-resistant dermatophytosis case report form	Form and Instruction	New
266001	Candida auris Case Report Form	Form and Instruction	New	Candida auris Case Report Form rev
266001	Candida auris Case Report Form	Form and Instruction	New	Candida auris Case Report Form
266001	Candida auris Case Report Form	Form and Instruction	New
266000	Blastomycosis Case Report Form	Form and Instruction	New	Blastomycosis Case Report Form rev
266000	Blastomycosis Case Report Form	Form and Instruction	New	Blastomycosis Case Report Form
266000	Blastomycosis Case Report Form	Form and Instruction	New
265999	Histoplasmosis Case Report Form	Form and Instruction	New	Histoplasmosis Case Report Form rev
265999	Histoplasmosis Case Report Form	Form and Instruction	New	Histoplasmosis Case Report Form
265999	Histoplasmosis Case Report Form	Form and Instruction	New
265998	Coccidioidomycosis Case Report Form	Form and Instruction	New	Coccidioidomycosis Case Report Form rev
265998	Coccidioidomycosis Case Report Form	Form and Instruction	New	Coccidioidomycosis Case Report Form
265998	Coccidioidomycosis Case Report Form	Form and Instruction	New
254011	Triazole-resistant Aspergillus fumigatus Case Report Form	Form and Instruction	Modified	Triazole-resistant Aspergillus fumigatus Case Report Form rev
254011	Triazole-resistant Aspergillus fumigatus Case Report Form	Form and Instruction	Modified	Triazole-resistant Aspergillus fumigatus Case Report Form
254011	Triazole-resistant Aspergillus fumigatus Case Report Form	Form and Instruction	Modified