OMB control number
Creation of State and Metropolitan Area Based Surveillance Projects for Amyotrophic Lateral Sclerosis (ALS)
OMB 0923-0043 · HHS/TSDR.
OMB 0923-0043
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 ALS Medical Record Verification Form | Form |
| ALS Case Reporting Form | Form |
 CDC Protocol#5923_ Amendment approval.doc | Supplementary Document |
| State-Metro ALS Surveillance Protocol-V6-CLEAN.doc | Supplementary Document |
| ICR#0923-0043_Justification for change-_June 2012.docx | Justification for No Material/Nonsubstantive Change |
 Line Listing |
Instruction |
| Training for Reporting |
Instruction |
| ALS Medical Record Verification Form |
Form |
| ALS Case Reporting Form |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201206-0923-001 | No material or nonsubstantive change to a currently approved collection | 2012-06-26 | Approved without change | |
| 201111-0923-002 | No material or nonsubstantive change to a currently approved collection | 2011-11-15 | Approved without change | |
| 201102-0923-001 | New collection (Request for a new OMB Control Number) | 2011-02-02 | Approved with change |