OMB control number

Ebola Virus Disease in the United States:CDC Support for Case and Contact Investigation

OMB 0920-1045 · HHS/CDC.

OMB 0920-1045

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
EVD Contact Tracing Investigation Form	Form and Instruction
EVD Case Investigation Form - United States	Form and Instruction
White House Evening Report	Form and Instruction
Symptom Monitoring Form - Environmental Lab Personnel	Form and Instruction
EVD Tracking Form for Environmental Services Personnel	Form and Instruction
Symptom Monitoring Form - Lab Personnel	Form and Instruction
EVD Tracking Form for Laboratory Personnel	Form and Instruction
Symptom Monitoring Form - Health Care Workers	Form and Instruction
EVD Tracking Form for Healthcare Workers with Direct Patient Contact	Form and Instruction
Symptom Monitoring Form	Form and Instruction
Ebola Virus Disease Person Under Investigation (PUI) Form	Form and Instruction
SupStmnt A US EVD CaseContInvest 20150123.docx	Supporting Statement A
Appndx2b ASTHO cmmnts CDC response 14JAN2015.docx	Supplementary Document
Appndx2a CSTE cmmnts CDC rsponse 14JAN2015.docx	Supplementary Document
SupStmnt B US EVD CaseContInvest 20150123.docx	Supporting Statement B
Att7 Generic End-of-Monitoring Letter.docx	Supplementary Document
Att4b Info for HCWs Treating Ebola Patients.docx	Supplementary Document
Att4a Guidance for Contacts of Ebola Patients.docx	Supplementary Document
Att3cGuidance for Eval Triage of Ebola Contacts.docx	Supplementary Document
Att3b Guidance for Eval Triage of Ebola Contacts.docx	Supplementary Document
Att3a Guidance for HD DA-AM of Returned Travelers.docx	Supplementary Document
Appndx3 SORN 09-20-0113 Epidemic Invest Case Records.pdf	Supplementary Document
Appndx1 42 USC 241 PH Service Act Section 301.pdf	Supplementary Document
Appndx2c_NACCHOcomments.docx	Supplementary Document
EVD Contact Tracing Investigation Form	Form and Instruction
EVD Case Investigation Form - United States	Form and Instruction
White House Evening Report	Form and Instruction
Symptom Monitoring Form - Environmental Lab Personnel	Form and Instruction
EVD Tracking Form for Environmental Services Personnel	Form and Instruction
Symptom Monitoring Form - Lab Personnel	Form and Instruction
EVD Tracking Form for Laboratory Personnel	Form and Instruction
Symptom Monitoring Form - Health Care Workers	Form and Instruction
EVD Tracking Form for Healthcare Workers with Direct Patient Contact	Form and Instruction
Symptom Monitoring Form	Form and Instruction
Ebola Virus Disease Person Under Investigation (PUI) Form	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
201501-0920-006	New collection (Request for a new OMB Control Number)	2015-01-14		Approved with change