OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

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

OMB 0920-1186 ยท HHS/CDC.

OMB 0920-1186

The CureTB program works to prevent the spread of tuberculosis (TB) among people who cross international borders. Information will be collected from the referring entities, which are state and local health departments and federal immigration and detention agencies. Whenever the referring entities provide clinical services to an individual with TB who has imminent plans to relocate, and an individual needs continuity of care in their new location, CDC CureTB is contacted to assist with coordinating that care.

The latest form for [NCEZID] Information Collection for Tuberculosis Data from Referring Entities to CureTB expires 2027-05-31 and is listed under ICR 202402-0920-003.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-1186 CureTB Partner Feedback (Satsifaction Assessment) Questionnaire 2Form and Instruction
Form 0920-1186 CureTB Partner Feedback (Satisfaction Assessment) Questionnaire 1Form 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 (document unavailable) Supplementary Document
Determination email to PIA (0920-1186).pdf Supplementary Document
Att. I- CureTB-PIA-Signed.pdf Supplementary Document
SSA_CureTB_022124_v2.docxSupporting 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 (document unavailable)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

Historical document collections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

OMB Details

Cure TB Transnational Notification (referral from LHDs)

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form CS347315-A (02/01/2024)CureTB Transnational NotificationPaper OnlyForm and instruction

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