OMB control number
COVID-19 by PCR Requisition Form
OMB 0937-0210 · HHS/OASH.
OMB 0937-0210
Collecting information on the PCR Lab Requisition form is necessary for the Office of the Assistant Secretary for Health (OASH) to perform its mission-critical work of ensuring that Community Based Testing Sites are properly managed and run. The data will inform the agency’s ability to tailor the national response, effectively manage the CBTS program, ensure the contracted laboratories and call center have the requisite information to process individual laboratory tests, and ensure individuals are quickly and accurately informed of their COVID-19 lab results.
The latest form for COVID-19 by PCR Requisition Form expires 2020-10-31 and is listed under ICR 202004-0937-001.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Emergency ICR SSA_COVID19 Lab Requistion Form_4.22.20 (omb)corrected.docx | Supporting Statement A |
 Attachment B_ Nasal, Self-Swab Informed Consent.pptx | Supplementary Document |
 COVID-19 Registrtion Form |
Other-Registration Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202004-0937-001 | New collection (Request for a new OMB Control Number) | 2020-04-23 | Approved with change |