OMB control number

[NCEZID] School-Based Active Surveillance (SBAS) of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Among Schoolchildren: Phase-2 of the National Roll-Out

OMB 0920-1396 · HHS/CDC.

OMB 0920-1396

The purpose of this submission is to request OMB authorization for a new information collection, “School-Based Active Surveillance (SBAS) of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Among Schoolchildren: Phase-2 of the National Roll-Out.” We are requesting three years to complete the information/data collection. This request is to expand the previous phase (Phase-1) that was under OMB Control No. 0920-1154. The new request is for Phase-2 of the project to field test and refine data collection tools and methods for determining the frequency of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) among other currently monitored chronic health conditions associated with school absenteeism and school withdrawal among US schoolchildren (grades kindergarten through twelve, K-12). Collection of information on better-known conditions that school nurses have already been tracking, in addition to ME/CFS, will allow assessment of the quality of this surveillance approach.

The latest form for [NCEZID] School-Based Active Surveillance (SBAS) of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Among Schoolchildren: Phase-2 of the National Roll-Out expires 2026-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-22HN School District Feedback Form Form and Instruction
Form 920-22HN Webinar 1 Feedback Form Form and Instruction
Form 0920-22HN Question Guide for Face-to-Face Evaluation Interviews Form and Instruction
Form 0920-22HN Attachment C_SBAS_Site Baseline Survey Form and Instruction
Form 0920-22HN Attachment B_SBAS_Demographic Data Collection Points Form and Instruction
Form 0920-1396 Electronic Platform Quarterly Chronic Absenteeism Data Reporting Form Form and Instruction
1_Supporting Statement A_SBAS_20260417_clean.docx Supporting Statement A
2_Supporting Statement B_SBAS_20260415.docx Supporting Statement B
4_Appropriation_Language_MECFS_20260415.docx Supplementary Document
10_IRB_CDC_091120AI-NE_SBAS.pdf Supplementary Document
10_IRB_Advarra_Pro00059494_Exempt Determination Notice_SBAS_Att H.pdf Supplementary Document
12_Public_Comments_60-day_FRN_OfSBAS_Responses_20260415.docx Public Comments
3_Published_60-day_FRN_CDC-2026-0166-0001_SBAS.pdf Supplementary Document
Attachment I_SBAS_Consent Form and Authorization for School District Representatives.docx Supplementary Document
Attachment J_SBAS_Consent Form and Authorization for School Nurses.docx Supplementary Document
Attachment H_SBAS_NASN IRB Exempt Determination Notice.pdf Supplementary Document
Attachment G_SBAS_Privacy Act Checklist Active Surveillance School Age Children.docx Supplementary Document
School District Feedback Form Form and Instruction
Webinar 1 Feedback Form Form and Instruction
Question Guide for Face-to-Face Evaluation Interviews Form and Instruction
Site Baseline Survey Form and Instruction
Demographic Data Collection Points Form and Instruction
Electronic Platform Quarterly Chronic Absenteeism Data Reporting Form Form and Instruction

All Historical Document Collections

202604-0920-002	Revision of a currently approved collection	2026-04-28
202212-0920-001 Approved without change	New collection (Request for a new OMB Control Number)	2022-12-13

OMB Details

Electronic Platform Quarterly Chronic Absenteeism Data Reporting Form

Federal Enterprise Architecture: Health - Public Health Monitoring

Form 0920-22HN

Electronic Platform Quarterly Chronic Absenteeism Data Reporting Form

Fillable Fileable

Form and instruction

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