Information Collection

Case Report Updates

IC 46032 under ICR 202412-0920-012 · OMB 0920-0573.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0573 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Case Report 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

IC Title:

Case Report 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:

table that charts list of 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

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 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	148,621	148,621
Annual IC Time Burden (Hours)	4,954	4,954
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.