OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Information Collection on Cause-Specific Absenteeism in Schools

OMB 0920-1039 ยท HHS/CDC.

OMB 0920-1039

The Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Global Migration and Quarantine (DGMQ), requests approval of a new information collection on Cause-Specific Absenteeism in Schools. This information collection aims to improve our understanding of the role of cause-specific absenteeism in schools in predicting community-wide influenza transmission, and will be used to strengthen the evidence-base of CDC's Pre-Pandemic Guidance prior to next pandemic. This revision adds household transmission component to the ongoing approved information collection

The latest form for Information Collection on Cause-Specific Absenteeism in Schools expires 2021-03-31 and is listed under ICR 201710-0920-016.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-1039 Household Component - Household Study Form B (Day 0, 7, and 14)Form
Form 0920-1039 Household Component - Household Study Form BForm
Form 0920-1039 Student Component - Household Study Form AForm
18)Form
Form 0920-1039 Student Component - ORCHARDS Telephone ScreenForm and Instruction
OMB changes document with consents 8.17.21.docx Supplementary Document
20200406 REDCap PIA signed.pdf Supplementary Document
Att C3 - consent_assent forms.docx Supplementary Document
Att C3a Assent 7 - 14.pdf Supplementary Document
Att C1 - School District Approval Letter.pdf Supplementary Document
Att. D4 - orchards newspaper ad.pdf Supplementary Document
Att D2 - Recruitment Flyer_teenager.docx Supplementary Document
Att D3 - Recruitment Flyer_kid.docx Supplementary Document
Att D1 - participant packet.pdf Supplementary Document
Att C5 IRB Approval_22Jan2021.pdf Supplementary Document
Att C6 -CDC IRB Deferral.pdf Supplementary Document
Published 60-day FRN.pdf Supplementary Document
Non-Substantive Change 0920-1039 ARI and Influenze Survillance Form.docx Justification for No Material/Nonsubstantive Change
SupStaA_WI School Absenteeism_final.docxSupporting Statement A
Att A3- Sec 301 PHSA (42 USC 241).pdf Supplementary Document
Att A2- CFR part 70.pdf Supplementary Document
Att A1- Sec 361 PHSA (42 USC 264).pdf Supplementary Document
SupStaB_WI School Absenteeism_final.docxSupporting Statement B
Household Component - Biospecimen Collection (Day 0, 7 and 14) Instruction
Household Component - Household Study Form B (Day 0, 7, and 14) Form
Household Component - Biospecimen Collection (Day 7 and 14) Instruction
Household Component - Household Study Form B Form
Student Component - Biospecimen Collection (Day 0) Instruction
Student Component - Household Study Form A Form
18) Form
Student Component - ORCHARDS Telephone Screen Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202108-0920-002 Reinstatement with change of a previously approved collection 2021-09-15 Approved without change
201710-0920-016 Revision of a currently approved collection 2017-11-13 Approved with change
201512-0920-009 No material or nonsubstantive change to a currently approved collection 2016-01-19 Approved without change
201407-0920-005 New collection (Request for a new OMB Control Number) 2014-07-25 Approved with change

OMB Details

Parents - ORCHARDS Telephone Screen

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form NAORCHARDS Screening FormNAForm and instruction

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