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Form 0920-0128 Congenital Syphilis Case Investigation and Report Form
Congenital Syphilis Case Investigation and Report Form
0920-0128_Attachment3c RvsdCSform2
Congenital Syphilis (CS) Case Investigation and Report Form Territorial Health Agencies
OMB: 0920-0128
OMB.report
HHS/CDC
OMB 0920-0128
ICR 201002-0920-007
IC 46587
Form 0920-0128 Congenital Syphilis Case Investigation and Report Form
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0128 can be found here:
2012-12-10 - Revision of a currently approved collection
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