[NCEZID] Characteristics of Cases of Priority Fungal Diseases

OMB 0920-1385

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-1385 Sporotrichosis case report form Form
Form 0920-1385 Mycetoma case report form Form
Form 0920-1385 Chromoblastomycosis case report form Form
Form 0920-1385 Antifungal-resistant dermatophytosis case report form Form
Form 0920-1385 Candida auris Case Report Form Form
Form 0920-1385 Blastomycosis Case Report Form Form
Form 0920-1385 Histoplasmosis Case Report Form Form
Form 0920-1385 Coccidioidomycosis Case Report Form Form
Form 0920-1385 Triazole-resistant Aspergillus fumigatus Case Report Form Form
Att 1 Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document
Att. 4 Non Research Determination.pdf Supplementary Document
Att. 5- Privacy Impact Assessment.pdf Supplementary Document
Att 4- Human Subjects Determination.pdf Supplementary Document
Att 2-Published 60-day FRN.pdf Supplementary Document
Att 1 Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document
SSB FungiSurv1_Revision_FINAL.docx Supporting Statement B
SSA FungiSurv1_Revision_FINAL.docx Supporting Statement A
Sporotrichosis case report form Form
Mycetoma case report form Form
Chromoblastomycosis case report form Form
Antifungal-resistant dermatophytosis case report form Form
Candida auris Case Report Form Form
Blastomycosis Case Report Form Form
Histoplasmosis Case Report Form Form
Coccidioidomycosis Case Report Form Form
Triazole-resistant Aspergillus fumigatus Case Report Form Form