CureTB Contact/Source Investigation (CI/SI) Notification (USHD - local & state)

[NCEZID] Information Collection for Tuberculosis Data from Referring Entities to CureTB

OMB: 0920-1186

IC ID: 226738

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

CureTB Contact/Source Investigation (CI/SI) Notification (USHD - local & state) 0920-1186
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CS347315-B (Revised 01/2024) CureTB Contact/Source Investigation (CI/SI) Notification Att. D- CureTBContactSource Investigation Notification-v2-508.pdf No   Paper Only

Health Public Health Monitoring

09-20-0171, Quarantine- and Traveler-related Activities Including Records for Contact Tracing Investigation and Notification under 42 CFR Parts 70 and 71  72 FR 70867

20 0
   
State, Local, and Tribal Governments
 
   50 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 100 0 0 0 0 100
Annual IC Time Burden (Hours) 50 0 0 0 0 50
Annual IC Cost Burden (Dollars) 0 0 -2,230 0 0 2,230

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