OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

[NCEZID] CryptoNet Case Report Form

OMB 0920-1360 ยท HHS/CDC.

OMB 0920-1360

The goal of the CryptoNet Case Report Form (CRF) is to define a set of data elements that can be used to identify exposure trends in outbreak- and non-outbreak-associated Cryptosporidium cases, to generate hypotheses about the source(s) of infection in clusters or outbreaks, and to identify strategies to prevent and control cases, clusters, or outbreaks. This Revision includes race/ethnicity question modification and updating some laboratory test options. Non-Substantive Change Request is submitted to modify single question for compliance with EO 14168.

The latest form for [NCEZID] CryptoNet Case Report Form expires 2028-02-29 and is listed under ICR 202504-0920-005.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-1360 CryptoNet Case Report Form (CRF)_REVISED 03APR2025Form and Instruction
CryptoNet Case Report FormForm and Instruction
CryptoNet Case Report FormForm and Instruction
Change Request Memo - EO14168 Template_CryptoNet_3.27.2025_FINAL.docxJustification for No Material/Nonsubstantive Change
Att E2_Privacy Impact Assessment.pdfSupplementary Document
Att E2_Privacy Impact Assessment.pdf Supplementary Document
Att E_Privacy Impact Assessment_DCIPHER SaaS.pdfSupplementary Document
Att E_Privacy Impact Assessment_DCIPHER SaaS.pdf Supplementary Document
Att D_Human Subjects Determination.pdfSupplementary Document
Att D_Human Subjects Determination.pdf Supplementary Document
Att B_ Published Federal Register Notice.pdfSupplementary Document
Att B_ Published Federal Register Notice.pdf Supplementary Document
Att A_Section 301 of the Public Health Service Act (42 USC 241) (1) (1) (1).pdfSupplementary Document
Att A_Section 301 of the Public Health Service Act (42 USC 241) (1) (1) (1).pdf Supplementary Document
SSB_CryptoNet_2024 revision package - CLEAN.docxSupporting Statement B
SSB_CryptoNet_2024 revision package - CLEAN.docxSupporting Statement B
SSA_CryptoNet_2024 revision package_CLEAN_final.docxSupporting Statement A
SSA_CryptoNet_2024 revision package_CLEAN_final.docxSupporting Statement A
CryptoNet Case Report Form Form and Instruction
CryptoNet Case Report Form Form and Instruction
CryptoNet Case Report Form Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202504-0920-005 No material or nonsubstantive change to a currently approved collection 2025-05-01
202412-0920-011 Revision of a currently approved collection 2025-01-10
202106-0920-015 New collection (Request for a new OMB Control Number) 2021-08-02 Approved without change