Adenovirus Typing Report Form

[NCIRD] National Disease Surveillance Program - II. Disease Summaries

Documents and Forms

Document Name Document Type
Form 0920-26-0003 Adenovirus Typing Report Form Form
0920-26-0003 National Adenovirus Type Reporting System (NATRS) Form AdenovirusSurveillanceForm_ver7.0_final .xlsx Form
NATRS_DataDictionary_8.2022_ct.xlsx Data Dictionary IC Document

Information Collection (IC) Details

IC Title:	Adenovirus Typing Report Form	Agency IC Tracking Number:	0920-26-0003

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
Form	0920-26-0003	National Adenovirus Type Reporting System (NATRS) Form	AdenovirusSurveillanceForm_ver7.0_final .xlsx	NA	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 13	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	52	52
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Data Dictionary	NATRS_DataDictionary_8.2022_ct.xlsx	12/08/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.