TB Indicators REDCap web form

Information Collection for Tuberculosis Data from Panel Physicians

Documents and Forms

Document Name Document Type
Form 0920-1102 TB Indicators REDCap web form Form
0920-1102 Tuberculosis Indicators Attachment B-TB Indicators REDCap Web Form.docx Form
0920-1102 Tuberculosis Indicators Attachment B-TB Indicators REDCap Web Form.docx Form

Information Collection (IC) Details

IC Title:	TB Indicators REDCap web form	Agency IC Tracking Number:	0920-1102

Is this a Common Form? No		IC Status: Modified

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	0920-1102	Tuberculosis Indicators	Attachment B-TB Indicators REDCap Web Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 333	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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	333	0	333
Annual IC Time Burden (Hours)	999	0	999
Annual IC Cost Burden (Dollars)	0	-105,115	105,115

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.