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Laboratory Updates
[NCHHSTP] National HIV Surveillance System (NHSS)
OMB: 0920-0573
IC ID: 205249
OMB.report
HHS/CDC
OMB 0920-0573
ICR 202408-0920-003
IC 205249
( )
Documents and Forms
Document Name
Document Type
Laboratory Updates
Form and Instruction
Laboratory Updates
Form and Instruction
Adult HIV Confidential Case Report Form
Att_3(a) Adult Case Report Form 2023 v17.pdf
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
Pediatric HIV Confidential Case Report Form
Att_3(b) Pediatric Case Report Form 2023 v18.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Laboratory Updates
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
None
Adult HIV Confidential Case Report Form
Att_3(a) Adult Case Report Form 2023 v17.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
None
Pediatric HIV Confidential Case Report Form
Att_3(b) Pediatric Case Report Form 2023 v18.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
SORN 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems HHS/CDC
FR Citation:
57 FR 62812
Number of Respondents:
59
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
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
597,670
0
0
0
0
597,670
Annual IC Time Burden (Hours)
4,981
0
0
0
0
4,981
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.