OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

[ATSDR] Assessment of Chemical Exposures (ACE) Investigations

OMB 0923-0051 ยท HHS/TSDR.

OMB 0923-0051

The ACE Investigations focus on performing rapid epidemiological assessments to assist state, regional, local, or tribal health departments (the requesting agencies) to respond to or prepare for acute chemical releases. States use the information to 1. Characterize exposure and acute health effects of respondents exposed, 2. Identify needs (i.e. medical and basic) of those exposed during the releases to aid in planning interventions in the community, 3. Assess the impact of the incidents on health services use and share lessons learned for use in planning for chemical incidents.

The latest form for [ATSDR] Assessment of Chemical Exposures (ACE) Investigations expires 2027-12-31 and is listed under ICR 202503-0923-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
AppxG MedChartAbstrct Form SAMPLE clean.docxSupplementary Document
AppxG MedChartAbstrct Form SAMPLE clean.docx Supplementary Document
AppxE General Survey SAMPLE clean.docxSupplementary Document
AppxE General Survey SAMPLE clean.docx Supplementary Document
AppxD Epi CASE Survey SAMPLE clean.docxSupplementary Document
AppxD Epi CASE Survey SAMPLE clean.docx Supplementary Document
0923-0051 Change Request Memo_UPDATE - EO14168.docxJustification for No Material/Nonsubstantive Change
0923-0051 Change Request Memo_UPDATE - EO14168.docx Justification for No Material/Nonsubstantive Change
AppxE General Survey SAMPLE_OIRA 11.7.24 clean.docxSupplementary Document
AppxE General Survey SAMPLE_OIRA 11.7.24 clean.docx Supplementary Document
AppxD Epi CASE Survey SAMPLE_OIRA 11.7.24 clean.docxSupplementary Document
AppxD Epi CASE Survey SAMPLE_OIRA 11.7.24 clean.docx Supplementary Document
AppxC Consent Forms_OIRA 11.18.24 clean.docxSupplementary Document
Att6 STARS project determination.pdfSupplementary Document
Att6 STARS project determination.pdf Supplementary Document
Att5 PIA EIWT - QTR3 - 2023 - CDC6794740.pdfSupplementary Document
Att5 PIA EIWT - QTR3 - 2023 - CDC6794740.pdf Supplementary Document
Att4c CDC DUA Standard Template v1.3.pdfSupplementary Document
Att4c CDC DUA Standard Template v1.3.pdf Supplementary Document
Att3d Steps for Using Gnric Clrnce ACE Invstgtn.docxSupplementary Document
Att3d Steps for Using Gnric Clrnce ACE Invstgtn.docx Supplementary Document
Att3c Burden Memo ACE Invstgtn.docxSupplementary Document
Att3c Burden Memo ACE Invstgtn.docx Supplementary Document
Att4b ACE Rules of Behavior 20210212 track changes.docxSupplementary Document
Att4b ACE Rules of Behavior 20210212 track changes.docx Supplementary Document
Att4a ACE Internal Manual of Procedures.docxSupplementary Document
Att4a ACE Internal Manual of Procedures.docx Supplementary Document
Att3b ACE Invstgtn GenIC Advnc Ntfictn.docxSupplementary Document
Att3b ACE Invstgtn GenIC Advnc Ntfictn.docx Supplementary Document
Att3a Request ACE Invstgtn Frm.docxSupplementary Document
Att3a Request ACE Invstgtn Frm.docx Supplementary Document
Att2 60D FRN ATSDR-2024-0002.pdfSupplementary Document
Att2 60D FRN ATSDR-2024-0002.pdf Supplementary Document
Att1 AuthLegisl-Cmbnd ACE Inv.docxSupplementary Document
Att1 AuthLegisl-Cmbnd ACE Inv.docx Supplementary Document
AppxG MedChartAbstrct Form SAMPLE.docxSupplementary Document
AppxG MedChartAbstrct Form SAMPLE.docx Supplementary Document
AppxF HospSurvey SAMPLE.docxSupplementary Document
AppxF HospSurvey SAMPLE.docx Supplementary Document
AppxE General Survey SAMPLE.docxSupplementary Document
AppxE General Survey SAMPLE.docx Supplementary Document
AppxD Epi CASE Survey SAMPLE.docxSupplementary Document
AppxD Epi CASE Survey SAMPLE.docx Supplementary Document
AppxC Consent Forms.docxSupplementary Document
AppxC Consent Forms.docx Supplementary Document
AppxB Eligibility Screener .docxSupplementary Document
AppxB Eligibility Screener .docx Supplementary Document
AppxA Summary of ACE Invstgns.docxSupplementary Document
AppxA Summary of ACE Invstgns.docx Supplementary Document
1 - ACE List of Attachments.docxSupplementary Document
1 - ACE List of Attachments.docx Supplementary Document
1 - ACE SSB 2024.docxSupporting Statement B
1 - ACE SSB 2024.docxSupporting Statement B
1 - ACE SSA 2024_OIRA 11.18.24 (002) clean.docxSupporting Statement A
1 - ACE SSA 2024_OIRA 11.18.24 (002) clean.docxSupporting Statement A

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202503-0923-001 No material or nonsubstantive change to a currently approved collection 2025-03-28 Approved without change
202410-0923-001 Revision of a currently approved collection 2024-10-02
202105-0923-001 Reinstatement with change of a previously approved collection 2021-05-26 Approved with change
201801-0923-001 Revision of a currently approved collection 2018-01-09 Approved without change
201607-0923-002 No material or nonsubstantive change to a currently approved collection 2016-07-21 Approved without change
201509-0923-002 No material or nonsubstantive change to a currently approved collection 2015-09-15 Approved without change
201409-0923-001 New collection (Request for a new OMB Control Number) 2014-10-09 Approved with change