Form 12 AR Lab Network Alert and Monthly Data Report Form for Ph

Form Approved

OMB Control No.: 0920-1310

Expiration date: XX/XX/XXXX

AR Lab Network Form for Phylogenetic Tree-level Mycotics Reporting (C. auris Whole Genome Sequencing)

Tree ID or REDCap ID

Date REDCap form created

Reference sequence used

Other reference

Phylogenetic tree file attachment

Phylogenetic tree metadata file attachment

Visualized phylogenetic tree file attachment

Visualized phylogenetic tree link

Phylogenetic tree interpretations

Additional comments on the phylogenetic tree

Public reporting burden of this collection of information is estimated to average 6 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB Control Number.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA 0920-1310