Information Collection Request

[NCEZID] Oropouche Virus Disease Outbreak

ICR 202410-0920-025 · OMB 0920-1446 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-25AU Sexual Contact Interview form Form and Instruction New Available
Form 0920-25AU Contact Tracing Survey Form New Available
Form 0920-25AU Symptom Diary Form New Available
Form 0920-25AU Follow-up clinical survey Form and Instruction New Available
Form 0920-25AU Baseline survey Form and Instruction New Available
Att. 13 Privacy Impact Assessment.pdf Supplementary Document Uploaded 2024-10-25 Available
Att. 13 Privacy Impact Assessment-2.pdf Supplementary Document Uploaded 2024-10-25 Available
Att. 12 Human Subjects Determination.pdf Supplementary Document Uploaded 2024-10-25 Available
Emergency Request Memo_OROV Response_10.25.24.docx Supplementary Document Uploaded 2024-10-25 Available
Att. 11 Script and consent for sexual partner interview and OROV testing .docx Supplementary Document Uploaded 2024-10-24 Available
Att. 9 Consent for medical and social information .docx Supplementary Document Uploaded 2024-10-24 Available
Att. 8 Background information and frequently asked questions for participants .docx Supplementary Document Uploaded 2024-10-24 Available
Supporting Statement B_OROV Response.docx Supporting Statement B Uploaded 2024-10-24 Available
Supporting Statement A_OROV Response_Revised.docx Supporting Statement A Uploaded 2024-10-24 Available
Att. 1 Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document Uploaded 2024-10-24 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
271899 Sexual Contact Interview form Form and Instruction New
271898 Contact Tracing Survey Form New
271897 Symptom Diary Form New
271896 Follow-up clinical survey Form and Instruction New
271895 Baseline survey Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2025 6 Months From Approved
2,850 0 0
663 0 0
0 0 0





Reginfo record details
5
table that charts list of burden
IC Title Form No. Form Name
Baseline survey 0920-25AU INITIAL CLINCAL AND SOCIAL SURVEY
Contact Tracing Survey 0920-25AU Contact Tracing Survey
Follow-up clinical survey 0920-25AU FOLLOW-UP CLINICAL SURVEY
Sexual Contact Interview form 0920-25AU Sexual Contact Interview form
Symptom Diary 0920-25AU Symptom Dairy

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,850 0 0 2,850 0 0
Annual Time Burden (Hours) 663 0 0 663 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No