OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

COLLABORATIVE PHYSICIAN-DIAGNOSED INFLUENZA MORBIDITY SURVEILLANCE SYSTEM

ICR 198210-0920-002 · OMB 0920-0124 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
110738 COLLABORATIVE PHYSICIAN-DIAGNOSED INFLUENZA MORBIDITY SURVEILLANCE SYSTEM Migrated
ICR Details
0920-0124 198210-0920-002
Historical Active
HHS/CDC
COLLABORATIVE PHYSICIAN-DIAGNOSED INFLUENZA MORBIDITY SURVEILLANCE SYSTEM
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 10/27/1982
Retrieve Notice of Action (NOA) 10/05/1982
  Inventory as of this Action Requested Previously Approved
10/31/1984 10/31/1984
4,500 0 0
730 0 0
0 0 0
WEEKLY REPORTING OF OFFICE VISITS AT WHICH INFLUENZA-LIKE ILLNESS IS DIAGNOSED BY FAMILY PRACTITIONERS WILL PROVIDE EARLY WARNING OF INFLUENZA OUTBREAKS AND GIVE INFORMATION ON RELATIVE IMPACT OF OUTBREA AND AGE RANGE OF AFFECTED PATIENTS.
None
None
No
1
IC Title Form No. Form Name
COLLABORATIVE PHYSICIAN-DIAGNOSED INFLUENZA MORBIDITY SURVEILLANCE SYSTEM
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,500 0 0 4,500 0 0
Annual Time Burden (Hours) 730 0 0 730 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/05/1982