Information Collection

NPS Office of Public Health Case Investigation and Outbreak Form

IC 256157 under ICR 202503-1024-001 · OMB 1024-0289.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0289 can be found here:

Documents and Forms

Document Name Document Type
Form NPS 10-687 National Park Service Office ofPublic Health Case Investigation and Outbreak Form NPS Office of Public Health Case Investigation and Outbreak Form Form
NPS_EPI Form 3.24.2023.pdf Other-Questionnaire
NPS_EPI Form 3.24.2023.pdf Other-Questionnaire
NPS 10-687 National Park Service Office ofPublic Health Case Invest 1024-0289 10-687 NPS_EPI Form (032025).pdf Form
NPS 10-687 National Park Service Office ofPublic Health Case Invest 1024-0289 10-687 NPS_EPI Form (032025).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NPS Office of Public Health Case Investigation and Outbreak Form	Agency IC Tracking Number:

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
Other-Questionnaire			NPS_EPI Form 3.24.2023.pdf		Yes	Yes	Fillable Fileable
Form	NPS 10-687	National Park Service Office ofPublic Health Case Investigation and Outbreak Form	1024-0289 10-687 NPS_EPI Form (032025).pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 100

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Requested	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	167	167
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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].