OMB control number

[NCEZID] Contact Investigation Outcome Reporting Forms

OMB 0920-0900 · HHS/CDC.

OMB 0920-0900

This is a request for revision to a currently approved information collection, OMB Control No 0920-0900, Contact Investigation Outcome Reporting Forms. The goal of this information collection is to obtain sufficient information on the results of contact investigations carried out by state, local, and territorial public health professionals or maritime medical crews to assess the impact of a potential or confirmed communicable disease of public health concern in a traveler, both in terms of further transmission of disease, health outcomes for cases and contacts, and to determine if further public health intervention is appropriate. These collections enable CDC to better assess the risk to individuals who may have been exposed to a potential or confirmed case of a communicable disease of concern while traveling to or within the United States. The information will be used to assist and collaborate with state, local, and territorial health departments, conveyance operators, port of entry partners, and international public health authorities to identify potential exposures and to determine the risk of infection and whether future public health interventions are needed. CDC is requesting changes to some of the forms in use under this control number, primarily the air travel-related contact investigation outcome reporting forms (TB, measles, rubella, and general). The changes are being requested to improve the quality and public health relevance of the information collected and reduce the burden on health departments.

The latest form for [NCEZID] Contact Investigation Outcome Reporting Forms expires 2027-09-30 and is listed under ICR 202408-0920-006.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-0900 Att G_Influenza Outbreak Enhanced Data Collection Form – MaritimeForm and Instruction
Form 0920-0900 Att F_Varicella Outbreak Enhanced Data Collection Form - MaritimeForm
Form 0920-0900 Att K_Rubella Aircraft Contact Investigation Outcome ReportingForm
Form 0920-0900 Att J_Measles Aircraft Contact Investigation Outcome Reporting FormForm
Form 0920-0900 Att E_TB Maritime Contact Investigation WorksheetForm
Form 0920-0900 Att I_General Land Contact Investigation Outcome Reporting FormForm
Form 0920-0900 Att H_General Aircraft Contact Investigation Outcome Reporting FormForm
Form 0920-0900 Att L_General Land Contact Investigation Outcome Reporting FormForm
0920-0900 SupSta B_FINAL.docxSupporting Statement B
0920-0900 SupSta A_FINAL_081924.docxSupporting Statement A
Att. M-QARS_PIA_Signed_2022-07-29.pdf Supplementary Document
Att. D Non-researach Determination.pdf Supplementary Document
Att. M-QARS_PIA.pdf Supplementary Document
Att. B-60 Day Federal Register Notice_0920-0900_6.4.2024.pdf Supplementary Document
Att. A3-42 CFR part 71 Authorizing Legislation.pdf Supplementary Document
Att. A2-42 CFR part 70 Authorizing Legislation.pdf Supplementary Document
Att. A1-Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document
Att G_Influenza Outbreak Enhanced Data Collection Form – Maritime Form and Instruction
Att F_Varicella Outbreak Enhanced Data Collection Form - Maritime Form
Att K_Rubella Aircraft Contact Investigation Outcome Reporting Form
Att J_Measles Aircraft Contact Investigation Outcome Reporting Form Form
Att E_TB Maritime Contact Investigation Worksheet Form
Att I_General Land Contact Investigation Outcome Reporting Form Form
Att H_General Aircraft Contact Investigation Outcome Reporting Form Form
Att L_General Land Contact Investigation Outcome Reporting Form Form

OMB Details

Att L_General Land Contact Investigation Outcome Reporting Form

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form 0920-0900General Land Contact Investigation Outcome Reporting FormFillable FileableForm

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