Follow-up and Treatment of Contacts to Tuberculosis Case Form - Electronic (Data Clerks and Program Managers)

Aggregate Reports for Tuberculosis Program Evaluation

Documents and Forms

Document Name Document Type
Form 0920-0457 Follow-up and Treatment of Contacts to Tuberculosis Case Form - Electronic (Data Clerks and Program Managers) Form and Instruction
0920-0457 Follow-up and Treatment of Contacts to Tuberculosis Case Att 3a ARPE CI_2022.docx Form and Instruction
0920-0457 Follow-up and Treatment of Contacts to Tuberculosis Case Att 3a ARPE CI_2022.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Follow-up and Treatment of Contacts to Tuberculosis Case Form - Electronic (Data Clerks and Program Managers)	Agency IC Tracking Number:	0920-0457

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0457	Follow-up and Treatment of Contacts to Tuberculosis Cases Form	Att 3a ARPE CI_2022.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 67	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	67	67
Annual IC Time Burden (Hours)	134	134
Annual IC Cost Burden (Dollars)	3,617	3,617

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.