OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

[NCIRD] National Disease Surveillance Program - II. Disease Summaries

ICR 202405-0920-001 · OMB 0920-0004 · Active

Forms and Documents
DocumentTypeStatusAvailability
US WHO Colloborating Laboratories Influenza Testing Methods Assessment Form Unchanged Repair queued
US WHO Colloborating Laboratories Influenza Testing Methods Assessment Form Unchanged Repair queued
Arthropod (Vector)-Borne Diseases (Non-Human Data) Form and Instruction Unchanged Available
Arthropod (Vector)-Borne Diseases (Non-Human Data) Form and Instruction Unchanged Repair queued
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF) Form and Instruction Unchanged Available
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF) Form and Instruction Unchanged Repair queued
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form Form and Instruction Unchanged Available
Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form Form and Instruction Unchanged Repair queued
Aggregate counts of persons exposed to Highly Pathogenic Avian Influenza (HPAI Form and Instruction Modified Repair queued
Aggregate counts of persons exposed to Highly Pathogenic Avian Influenza (HPAI Form and Instruction Modified Repair queued
Suspect Respiratory Virus Patient Form Form Unchanged Available
Suspect Respiratory Virus Patient Form Form Unchanged Repair queued
Form CDC 55.20E U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E Form Unchanged Available
Form CDC 55.20E U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E Form Unchanged Repair queued
Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form Form Unchanged Available
Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form Form Unchanged Repair queued
Adenovirus Typing Report Form Form Unchanged Available
Adenovirus Typing Report Form Form Unchanged Repair queued
Antiviral Resistant Influenza Infection Case Report Form Form Unchanged Available
Antiviral Resistant Influenza Infection Case Report Form Form Unchanged Repair queued
Human Infections with Novel Influenza A Virus Severe Outcomes Form Unchanged Repair queued
Human Infections with Novel Influenza A Virus Severe Outcomes Form Unchanged Repair queued
Influenza Associated Pediatric Mortality Case Report Form Form Unchanged Available
Influenza Associated Pediatric Mortality Case Report Form Form Unchanged Missing upstream
WHO Collaborating Center for Influenza Virus Surveillance Form Unchanged Available
WHO Collaborating Center for Influenza Virus Surveillance Form Unchanged Repair queued
Human Infection with Novel Influenza A Virus Case Report Form Form Modified Repair queued
Human Infection with Novel Influenza A Virus Case Report Form Form Modified Repair queued
Novel Influenza A Virus Case Screening Form Form Modified Available
Novel Influenza A Virus Case Screening Form Form Modified Repair queued
Viral Gastroenteritis Outbreak Submission Form Form Unchanged Repair queued
Viral Gastroenteritis Outbreak Submission Form Form Unchanged Repair queued
Form CDC 55.83A National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Form Unchanged Available
Form CDC 55.83A National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Form Unchanged Missing upstream
Form CDC 55.90 National Enterovirus Surveillance Report 55.9 Form Unchanged Available
Form CDC 55.90 National Enterovirus Surveillance Report 55.9 Form Unchanged Repair queued
ICR Change request memo_OMB 0920-0004 20240503.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-05-06 Available
ICR Change request memo_OMB 0920-0004 20240503.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-05-06 Missing upstream
Attachment DD 103122NL-NR.pdf Supplementary Document Uploaded 2023-01-26 Available
Attachment DD 103122NL-NR.pdf Supplementary Document Uploaded 2023-01-26 Repair queued
Attachment C_Disease Summaries 0920-0004 _2023 FINAL_final.docx Supplementary Document Uploaded 2023-01-26 Available
Attachment C_Disease Summaries 0920-0004 _2023 FINAL_final.docx Supplementary Document Uploaded 2023-01-26 Repair queued
Attachment B 60 Day Federal Register Notice.pdf Supplementary Document Uploaded 2023-01-26 Repair queued
Attachment B 60 Day Federal Register Notice.pdf Supplementary Document Uploaded 2023-01-26 Repair queued
Authorizing Legislation.pdf Supplementary Document Uploaded 2023-01-26 Repair queued
Authorizing Legislation.pdf Supplementary Document Uploaded 2023-01-26 Repair queued
SSB 0920-0004 REINSTATEMENT 2023 FINAL.docx Supporting Statement B Uploaded 2023-01-26 Available
SSB 0920-0004 REINSTATEMENT 2023 FINAL.docx Supporting Statement B Uploaded 2023-01-26 Repair queued
SSA 0920-0004 REINSTATEMENT 2023 FINAL_final.docx Supporting Statement A Uploaded 2023-01-26 Available
SSA 0920-0004 REINSTATEMENT 2023 FINAL_final.docx Supporting Statement A Uploaded 2023-01-26 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
37707 US WHO Colloborating Laboratories Influenza Testing Methods Assessment Form Unchanged
37707 US WHO Colloborating Laboratories Influenza Testing Methods Assessment Form Unchanged
258096 Arthropod (Vector)-Borne Diseases (Non-Human Data) Form and Instruction Unchanged
258096 Arthropod (Vector)-Borne Diseases (Non-Human Data) Form and Instruction Unchanged
258095 Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF) Form and Instruction Unchanged
258095 Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF) Form and Instruction Unchanged
258094 Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form Form and Instruction Unchanged
258094 Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Short Form Form and Instruction Unchanged
258093 Aggregate counts of persons exposed to Highly Pathogenic Avian Influenza (HPAI Form and Instruction Modified
258093 Aggregate counts of persons exposed to Highly Pathogenic Avian Influenza (HPAI Form and Instruction Modified
228082 Suspect Respiratory Virus Patient Form Form Unchanged
228082 Suspect Respiratory Virus Patient Form Form Unchanged
228068 U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E Form Unchanged
228068 U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E Form Unchanged
212473 Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form Form Unchanged
212473 Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form Form Unchanged
212472 Adenovirus Typing Report Form Form Unchanged
212472 Adenovirus Typing Report Form Form Unchanged
212471 Antiviral Resistant Influenza Infection Case Report Form Form Unchanged
212471 Antiviral Resistant Influenza Infection Case Report Form Form Unchanged
212470 Human Infections with Novel Influenza A Virus Severe Outcomes Form Unchanged
212470 Human Infections with Novel Influenza A Virus Severe Outcomes Form Unchanged
199052 Influenza Virus Electronic year round PHIN-MS Other-Variables for Reporting Unchanged
199051 Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements Other-Variables for Electronic Reporting Unchanged
199050 Influenza Associated Pediatric Mortality Case Report Form Form Unchanged
199050 Influenza Associated Pediatric Mortality Case Report Form Form Unchanged
199049 WHO Collaborating Center for Influenza Virus Surveillance Form Unchanged
199049 WHO Collaborating Center for Influenza Virus Surveillance Form Unchanged
199043 Human Infection with Novel Influenza A Virus Case Report Form Form Modified
199043 Human Infection with Novel Influenza A Virus Case Report Form Form Modified
199040 Novel Influenza A Virus Case Screening Form Form Modified
199040 Novel Influenza A Virus Case Screening Form Form Modified
178374 Viral Gastroenteritis Outbreak Submission Form Form Unchanged
178374 Viral Gastroenteritis Outbreak Submission Form Form Unchanged
178365 National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Form Unchanged
178365 National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Form Unchanged
178364 National Enterovirus Surveillance Report 55.9 Form Unchanged
178364 National Enterovirus Surveillance Report 55.9 Form Unchanged
ICR Details
StatusActive
Agency/SubagencyHHS/CDC
OMB Control No0920-0004
Type of Information CollectionNo material or nonsubstantive change to a currently approved collection
Previous ICR Reference No202301-0920-009
Agency Tracking No0920-0004
Date Submitted to OIRA2024-05-07
Requested Expiration Date1969-12-31