OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

[NIOSH] National Disease Surveillance Program

OMB 0920-0009 · HHS/CDC.

OMB 0920-0009

The purpose of this data collection is to collect disease specific surveillance reports of rare, uncommon, or infrequent diseases. The data will be used to determine the prevalence of diseases dangerous to public health. The data will also be used for planning and evaluating effective programs for prevention and control of infectious diseases. Disease incidence is needed to study present and emerging disease problems. Case data will be transmitted to CDC electronically or hard copy from State and Local Health Departments. This Revision includes reduction of burden hours due to fewer respondents expected. Updates to the format for collecting race and ethnicity have been made to the acute flaccid myelitis data collection form and will be implemented once the package is approved. We seek to use the modified version of “Race and Ethnicity Question with Minimum Categories Only”.

The latest form for [NIOSH] National Disease Surveillance Program expires 2029-03-31 and is listed under ICR 202601-0920-004.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-0009 Acute Flaccid Myelitis: Patient Summary FormForm and Instruction
Form 0920-0009 Reye Syndrome formForm and Instruction
Form 0920-0009 Kawasaki Syndrome formForm and Instruction
Form 0920-0009 Att D2_Kawasaki SyndromeForm and Instruction
Form 0920-0009 CJD formForm and Instruction
Public Comment 1 Kawasaki Disease_Anonymous.pdf (document unavailable)Public Comments
Public Comment 2 Response.pdf (document unavailable)Public Comments
Public Comment 3_CJD and other diseases.pdf (document unavailable)Public Comments
Public Comment 4 Response.pdfPublic Comments
H. PIA CJD, Reye Syndrome, Kawasaki.pdfSupplementary Document
H. PIA CJD, Reye Syndrome, Kawasaki.pdf Supplementary Document
G. PIA AFM.pdfSupplementary Document
G. PIA AFM.pdf Supplementary Document
F. Standardized Case Definition for AFM.pdfSupplementary Document
E. Non-research determination.pdfSupplementary Document
E. Non-research determination.pdf Supplementary Document
C. Surveillance Summaries.docxSupplementary Document
B. Published 60-Day Federal Register 0920-0009.pdfSupplementary Document
A. Authorizing legislation.pdfSupplementary Document
H. PIA CJD, Reye Syndrome, Kawasaki.pdfSupplementary Document
H. PIA CJD, Reye Syndrome, Kawasaki.pdf Supplementary Document
G. PIA AFM.pdfSupplementary Document
F. Standardized Case Definition for AFM.pdfSupplementary Document
E. Non-research determination.pdfSupplementary Document
C. Surveillance Summaries.docxSupplementary Document
B. Published 60-day NDSP.pdfSupplementary Document
A. Authorizing legislation.docxSupplementary Document
SSB 0009 - 2025 Revision.docxSupporting Statement B
SSA 0009 - 2025 Revision.docxSupporting Statement A
Att D-4_Acute Flaccid Myelitis Form and Instruction
Att D-4_Acute Flaccid Myelitis Form and Instruction
Att D-3_Reye Syndrome Form and Instruction
Att D-3_Reye Syndrome Form and Instruction
Att D2_Kawasaki Syndrome Form and Instruction
Att D2_Kawasaki Syndrome Form and Instruction
Att D-1_CJD Form and Instruction
Att D-1_CJD Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202601-0920-004 Revision of a currently approved collection 2026-01-21 Approved with change
202208-0920-011 Revision of a currently approved collection 2022-08-26 Approved without change
202207-0920-013 No material or nonsubstantive change to a currently approved collection 2022-07-29 Approved without change
201912-0920-004 No material or nonsubstantive change to a currently approved collection 2019-12-09 Approved without change
201905-0920-011 Extension without change of a currently approved collection 2019-06-26 Approved without change
201901-0920-013 No material or nonsubstantive change to a currently approved collection 2019-02-01 Approved without change
201708-0920-015 No material or nonsubstantive change to a currently approved collection 2017-08-16 Approved without change
201601-0920-001 Revision of a currently approved collection 2016-01-11 Approved with change
201502-0920-003 No material or nonsubstantive change to a currently approved collection 2015-02-10 Approved without change
201410-0920-002 No material or nonsubstantive change to a currently approved collection 2014-10-03 Approved without change
201401-0920-007 No material or nonsubstantive change to a currently approved collection 2014-01-28 Approved without change
201311-0920-001 No material or nonsubstantive change to a currently approved collection 2013-11-05 Approved without change
201305-0920-010 No material or nonsubstantive change to a currently approved collection 2013-05-28 Approved without change
201303-0920-007 Revision of a currently approved collection 2013-03-14 Approved without change
201003-0920-010 Revision of a currently approved collection 2010-03-23 Approved without change
200906-0920-018 No material or nonsubstantive change to a currently approved collection 2009-06-19 Approved without change
200807-0920-006 No material or nonsubstantive change to a currently approved collection 2008-07-30 Approved without change
200707-0920-005 No material or nonsubstantive change to a currently approved collection 2007-07-25 Approved without change
200611-0920-008 Revision of a currently approved collection 2006-11-29 Approved with change
200307-0920-011 No material or nonsubstantive change to a currently approved collection 2003-07-29 Approved without change
200212-0920-008 Revision of a currently approved collection 2002-12-23 Approved without change
200104-0920-010 Extension without change of a currently approved collection 2001-04-30 Approved without change
199911-0920-001 Reinstatement with change of a previously approved collection 1999-11-19 Approved without change
199305-0920-002 Reinstatement with change of a previously approved collection 1993-05-20 Approved without change
199005-0920-005 Revision of a currently approved collection 1990-05-25 Approved without change
198910-0920-002 Revision of a currently approved collection 1989-10-11 Approved without change
198707-0920-003 No material or nonsubstantive change to a currently approved collection 1987-07-31 Approved with change
198609-0920-002 Revision of a currently approved collection 1986-09-03 Approved without change
198405-0920-001 Revision of a currently approved collection 1984-05-10 Approved without change
198309-0920-001 Revision of a currently approved collection 1983-09-23 Approved without change
198304-0920-001 Revision of a currently approved collection 1983-04-27 Approved without change
198104-0920-003 Revision of a currently approved collection 1981-04-24 Approved without change
198011-0920-004 Revision of a currently approved collection 1980-11-26 Approved without change
198005-0920-001 Revision of a currently approved collection 1980-05-15 Approved without change
197809-0920-002 Revision of a currently approved collection 1978-09-25 Approved without change
197706-0920-001 No material or nonsubstantive change to a currently approved collection 1977-06-28 Approved with change
197612-0920-001 Revision of a currently approved collection 1976-12-27 Approved without change
197610-0920-001 Revision of a currently approved collection 1976-10-07 Approved without change
197604-0920-001 Revision of a currently approved collection 1976-04-06 Approved without change
197603-0920-001 No material or nonsubstantive change to a currently approved collection 1976-03-24 Approved with change
197509-0920-001 No material or nonsubstantive change to a currently approved collection 1975-09-16 Approved with change
197409-0920-002 Revision of a currently approved collection 1974-09-30 Approved without change

OMB Details

Att D-1_CJD

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form 0920-0009CJD formFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.