Information Collection Request
[NCEZID] Information Collection for Tuberculosis Data from Referring Entities to CureTB
ICR 202402-0920-003 · OMB 0920-1186 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 0920-1186 CureTB Partner Feedback (Satsifaction Assessment) Questionnaire 2 |
Form and Instruction | Modified | Repair queued |
| Form 0920-1186 CureTB Partner Feedback (Satisfaction Assessment) Questionnaire 1 |
Form and Instruction | Modified | Repair queued |
| Form CS347315-A (02/01/ CureTB Transnational Notification (TB patients referred by ICE) |
Form and Instruction | Modified | Repair queued |
| Form 0920-1186 Telephone Script Clinician /Foreign Health Authority Follow-up (CureTB) |
Form and Instruction | Modified | Repair queued |
| Form CS347315-B (Revise CureTB Contact/Source Investigation (CI/SI) Notification (USHD - local & state) |
Form and Instruction | Modified | Missing upstream |
| Form CS347315-A (02/01/ CureTB Transnational Notification (TB patients referred by USHD) |
Form and Instruction | Modified | Repair queued |
| Form CS347315-A (02/01/ Cure TB Transnational Notification (referral from LHDs) |
Form and Instruction | Modified | Repair queued |
 Att. J-CureTB Notification Email.pdf |
Supplementary Document | Uploaded 2024-02-21 | Repair queued |
| Determination email to PIA (0920-1186).pdf |
Supplementary Document | Uploaded 2024-02-09 | Repair queued |
| Att. I- CureTB-PIA-Signed.pdf |
Supplementary Document | Uploaded 2024-02-21 | Repair queued |
 SSA_CureTB_022124_v2.docx |
Supporting Statement A | Uploaded 2024-02-21 | Repair queued |
| Att. H- Human Subjects Determination.pdf |
Supplementary Document | Uploaded 2024-02-21 | Missing upstream |
| Att. B- Published 60-Day Federal Register Notice.pdf |
Supplementary Document | Uploaded 2024-02-09 | Repair queued |
| Att. A5 - Section 311.pdf |
Supplementary Document | Uploaded 2020-06-08 | Repair queued |
| Att. A4 - Section 301.pdf |
Supplementary Document | Uploaded 2020-06-08 | Repair queued |
| Att. A3 - 42 CFR Part 71.pdf |
Supplementary Document | Uploaded 2020-06-08 | Missing upstream |
| Att. A2 - 42 CFR Part 70.pdf |
Supplementary Document | Uploaded 2020-06-08 | Repair queued |
| Att. A1 - Section 361 of the Public Health Service Act (42 USC 264).pdf |
Supplementary Document | Uploaded 2020-06-08 | Missing upstream |
| Supporting Statement B_CureTB.docx |
Supporting Statement B | Uploaded 2024-02-21 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 252225 |  CureTB Partner Feedback (Satsifaction Assessment) Questionnaire 2 |
Form and Instruction | Modified | |
| 252223 | CureTB Partner Feedback (Satisfaction Assessment) Questionnaire 1 |
Form and Instruction | Modified | |
| 242057 | CureTB Transnational Notification (TB patients referred by ICE) |
Form and Instruction | Modified | |
| 226739 | Telephone Script Clinician /Foreign Health Authority Follow-up (CureTB) |
Form and Instruction | Modified | |
| 226738 | CureTB Contact/Source Investigation (CI/SI) Notification (USHD - local & state) |
Form and Instruction | Modified | |
| 226737 | CureTB Transnational Notification (TB patients referred by USHD) |
Form and Instruction | Modified | |
| 226736 | Cure TB Transnational Notification (referral from LHDs) |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-1186 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202203-0920-003 |
| Agency Tracking No | 0920-1186 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |