[NCEZID] Traveler-based Genomic Surveillance Questionnaire (24EQ)

[NCEZID] Traveler-based Genomic Surveillance

OMB: 0920-1406

IC ID: 259028

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Form
Other-WORD
Other-WORD
Form
Form
Form and Instruction
Form and Instruction
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Information Collection (IC) Details

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[NCEZID] Traveler-based Genomic Surveillance Questionnaire (24EQ) 0920-1406-24EQ
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-1406 TGS Updated Digital Collection + Double Collection Questionnaire Attachment 3 - Information Collection instrument.docx Yes Yes Fillable Fileable
Other-WORD Attachment 4C - TGS potential additional questions_symptoms_clean.docx Yes Yes Fillable Fileable
Form and Instruction 0920-1406 TGS Updated Digital Collection + Double Collection Questionnaire_rev. 2024 Attachment 3 - Information Collection instrument_clean_2024_April8.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

555,000 0
   
Individuals or Households
 
   90 %

  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 555,000 0 0 0 0 555,000
Annual IC Time Burden (Hours) 46,250 0 0 0 0 46,250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Potential Additional Questions Attachment 4C - Potential additional questions.docx 03/09/2023
Att 4C_TGS_Additional Questions Attachment 4C - TGS potential additional questions_RSVclean.docx 08/11/2023
Att 4C - TGS potential additional questions (Track changes) 24BT Attachment 4C - TGS potential additional questions_symptoms_tracked.docx 01/05/2024
TGS Updated Digital Collection + Double Collection Questionnaire (DRAFT) Attachment 3 - Information Collection instrument_tracked_2024_April8.docx 04/10/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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