[NCEZID] Information Collection for Tuberculosis Data from Referring Entities to CureTB

OMB 0920-1186

The objective of this information collection is to facilitate CDC coordinating of the continuity of care for individuals affected by TB who enter US jurisdictions from foreign nations who or who leave US jurisdictions bound for foreign nations.

The latest form for [NCEZID] Information Collection for Tuberculosis Data from Referring Entities to CureTB expires 2021-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-1186 CureTB Partner Feedback (Satsifaction Assessment) Questionnaire 2 Form and Instruction
Form 0920-1186 CureTB Partner Feedback (Satisfaction Assessment) Questionnaire 1 Form and Instruction
Form CS347315-A (02/01/ CureTB Transnational Notification (TB patients referred by ICE) Form and Instruction
Form 0920-1186 Telephone Script Clinician /Foreign Health Authority Follow-up (CureTB) Form and Instruction
Form CS347315-B (Revise CureTB Contact/Source Investigation (CI/SI) Notification (USHD - local & state) Form and Instruction
Form CS347315-A (02/01/ CureTB Transnational Notification (TB patients referred by USHD) Form and Instruction
Form CS347315-A (02/01/ Cure TB Transnational Notification (referral from LHDs) Form and Instruction
Att. J-CureTB Notification Email.pdf Supplementary Document
Determination email to PIA (0920-1186).pdf Supplementary Document
Att. I- CureTB-PIA-Signed.pdf Supplementary Document
SSA_CureTB_022124_v2.docx Supporting Statement A
Att. H- Human Subjects Determination.pdf Supplementary Document
Att. B- Published 60-Day Federal Register Notice.pdf Supplementary Document
Att. A5 - Section 311.pdf Supplementary Document
Att. A4 - Section 301.pdf Supplementary Document
Att. A3 - 42 CFR Part 71.pdf Supplementary Document
Att. A2 - 42 CFR Part 70.pdf Supplementary Document
Att. A1 - Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document
Supporting Statement B_CureTB.docx Supporting Statement B
CureTB Partner Feedback (Satsifaction Assessment) Questionnaire 2 Form and Instruction
CureTB Partner Feedback (Satisfaction Assessment) Questionnaire 1 Form and Instruction
CureTB Transnational Notification (TB patients referred by ICE) Form and Instruction
Telephone Script Clinician /Foreign Health Authority Follow-up (CureTB) Form and Instruction
CureTB Contact/Source Investigation (CI/SI) Notification (USHD - local & state) Form and Instruction
CureTB Transnational Notification (TB patients referred by USHD) Form and Instruction
Cure TB Transnational Notification (referral from LHDs) Form and Instruction

All Historical Document Collections

202402-0920-003 Approved with change	Revision of a currently approved collection	2024-02-22
202203-0920-003 Approved without change	No material or nonsubstantive change to a currently approved collection	2022-03-17
202004-0920-019	Revision of a currently approved collection	2020-06-15
201705-0920-004 Approved without change	New collection (Request for a new OMB Control Number)	2017-05-10

OMB Details

Cure TB Transnational Notification - Registered Nurses/Nurse Practictioners

Federal Enterprise Architecture: Health - Public Health Monitoring

Form 16AWE

Attachment D CureTB_Transnational_Notification_CureTB 0722

Fillable Printable

Form and instruction

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