POE Public Health Risk Assessment Form - CDC Marburg Response

[NCEZID] 2024 Marburg Airport Entry Questionnaires

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1443 can be found here:

Documents and Forms

Document Name Document Type
POE Public Health Risk Assessment Form - CDC Marburg Response Form and Instruction
POE Public Health Risk Assessment Form - CDC Marburg Response Form and Instruction
CDC RISK ASSESSMENT AT POE (CDC Secondary) – Marburg Res Attachment D - POE Public Health Risk Assessment Form_CDC Marburg Response_10 08 2024.docx Form and Instruction
CDC RISK ASSESSMENT AT POE (CDC Secondary) – Marburg Res Attachment D - POE Public Health Risk Assessment Form_CDC Marburg Response_10 08 2024.docx Form and Instruction
0920-1443 CDC RISK ASSESSMENT AT POE (CDC Secondary) – Marburg Res Attachment D- POE Public Health Risk Assessment Form_Marburg 16OCT2024.docx.docx Form and Instruction
0920-1443 CDC RISK ASSESSMENT AT POE (CDC Secondary) – Marburg Res Attachment D- POE Public Health Risk Assessment Form_Marburg 16OCT2024.docx.docx Form and Instruction

Information Collection (IC) Details

IC Title:	POE Public Health Risk Assessment Form - CDC Marburg Response	Agency IC Tracking Number:	0920-25AE

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

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	n/a	CDC RISK ASSESSMENT AT POE (CDC Secondary) – Marburg Response	Attachment D - POE Public Health Risk Assessment Form_CDC Marburg Response_10 08 2024.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-1443	CDC RISK ASSESSMENT AT POE (CDC Secondary) – Marburg Response	Attachment D- POE Public Health Risk Assessment Form_Marburg 16OCT2024.docx.docx	N/A	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: Quarantine- and Traveler-Related Activities, including Records for Contact Tracing Investigation and Notification under 42 CFR Parts 70 and 71	FR Citation: 83 FR 6591

Number of Respondents: 4,380	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	4,380	4,380
Annual IC Time Burden (Hours)	1,460	1,460
Annual IC Cost Burden (Dollars)	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.