OMB control number
Long-term sequela of Rocky Mountain Spotted Fever (RMSF)
OMB 0920-1267 · HHS/CDC.
OMB 0920-1267
The goal of this study is to describe persistent neurological damage in patients who were hospitalized with RMSF. Resulting data will provide information to healthcare providers, patients, and policy-makers about the long term consequences of severe RMSF, including length of time to recovery, and risk factors during acute illness which may be associated with long-term impairment.
The latest form for Long-term sequela of Rocky Mountain Spotted Fever (RMSF) expires 2022-08-31 and can be found here.
Latest Forms, Documents, and Supporting Material
Document Name |
|---|
 Neurologic Exam Form (document unavailable)Form |
Form |
Supplementary Document |
Supplementary Document |
| 7. Consent documents.pdf (document unavailable) Supplementary Document |
Supplementary Document |
Supplementary Document |
| 2. 60-day FRN.pdf (document unavailable) Supplementary Document |
| 1. Section 301 of the Public Health Service Act (42 USC 241).pdf (document unavailable) Supplementary Document |
Supporting Statement B |
Supporting Statement A |
Patient Screening Questionnaire
9. IRB Continuation Memo.docx
Neurologic Exam Form All Historical Document Collections
|
Approved with change |
New collection (Request for a new OMB Control Number) | 2019-05-02 |
OMB Details
Patient Screening Questionnaire
Federal Enterprise Architecture: Health - Public Health Monitoring
| Form none | Patient Screener | Paper Only | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.