[NCEZID] CryptoNet Case Report Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-1360 CryptoNet Case Report Form (CRF)_REVISED 03APR2025	Form and Instruction	Modified	Available
CryptoNet Case Report Form	Form and Instruction	Modified	Repair queued
CryptoNet Case Report Form	Form and Instruction	Modified	Repair queued
Change Request Memo - EO14168 Template_CryptoNet_3.27.2025_FINAL.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-03	Repair queued
Change Request Memo - EO14168 Template_CryptoNet_3.27.2025_FINAL.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-03	Repair queued
Att E2_Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2024-12-17	Available
Att E2_Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2024-12-17	Repair queued
Att E_Privacy Impact Assessment_DCIPHER SaaS.pdf	Supplementary Document	Uploaded 2024-12-17	Available
Att E_Privacy Impact Assessment_DCIPHER SaaS.pdf	Supplementary Document	Uploaded 2024-12-17	Repair queued
Att D_Human Subjects Determination.pdf	Supplementary Document	Uploaded 2024-12-17	Available
Att D_Human Subjects Determination.pdf	Supplementary Document	Uploaded 2024-12-17	Repair queued
Att B_ Published Federal Register Notice.pdf	Supplementary Document	Uploaded 2024-12-17	Available
Att B_ Published Federal Register Notice.pdf	Supplementary Document	Uploaded 2024-12-17	Repair queued
Att A_Section 301 of the Public Health Service Act (42 USC 241) (1) (1) (1).pdf	Supplementary Document	Uploaded 2024-12-17	Available
Att A_Section 301 of the Public Health Service Act (42 USC 241) (1) (1) (1).pdf	Supplementary Document	Uploaded 2024-12-17	Repair queued
SSB_CryptoNet_2024 revision package - CLEAN.docx	Supporting Statement B	Uploaded 2024-12-17	Available
SSB_CryptoNet_2024 revision package - CLEAN.docx	Supporting Statement B	Uploaded 2024-12-17	Missing upstream
SSA_CryptoNet_2024 revision package_CLEAN_final.docx	Supporting Statement A	Uploaded 2025-02-25	Available
SSA_CryptoNet_2024 revision package_CLEAN_final.docx	Supporting Statement A	Uploaded 2025-02-25	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
248663	CryptoNet Case Report Form	Form and Instruction	Modified	CryptoNet Case Report Form (CRF)_REVISED 03APR2025
248663	CryptoNet Case Report Form	Form and Instruction	Modified	CryptoNet Case Report Form
248663	CryptoNet Case Report Form	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1360	ICR Reference No: 202504-0920-005
Status: Active	Previous ICR Reference No: 202412-0920-011
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1360-25-0089
Title: [NCEZID] CryptoNet Case Report Form
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/09/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/01/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2028	02/29/2028	02/29/2028
Responses	500	0	500
Time Burden (Hours)	125	0	125
Cost Burden (Dollars)	0	0	0

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Abstract: The goal of the CryptoNet Case Report Form (CRF) is to define a set of data elements that can be used to identify exposure trends in outbreak- and non-outbreak-associated Cryptosporidium cases, to generate hypotheses about the source(s) of infection in clusters or outbreaks, and to identify strategies to prevent and control cases, clusters, or outbreaks. This Revision includes race/ethnicity question modification and updating some laboratory test options. Non-Substantive Change Request is submitted to modify single question for compliance with EO 14168.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 84144	10/21/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 1500	01/08/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
CryptoNet Case Report Form	0920-1360, n/a	CryptoNet Case Report Form ,   CryptoNet Case Report Form (CRF)_REVISED 03APR2025

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ICR Summary of Burden

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	500	500	0	0	0	0
Annual Time Burden (Hours)	125	125	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $12,719

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/01/2025

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