Information Collection Request

[NCEZID] CryptoNet Case Report Form

ICR 202504-0920-005 · OMB 0920-1360 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-1360 CryptoNet Case Report Form (CRF)_REVISED 03APR2025 Form and Instruction Modified Repair queued
CryptoNet Case Report Form Form and Instruction Modified Repair queued
CryptoNet Case Report Form Form and Instruction Modified Repair queued
Change Request Memo - EO14168 Template_CryptoNet_3.27.2025_FINAL.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-03 Repair queued
Change Request Memo - EO14168 Template_CryptoNet_3.27.2025_FINAL.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-03 Repair queued
Att E2_Privacy Impact Assessment.pdf Supplementary Document Uploaded 2024-12-17 Repair queued
Att E2_Privacy Impact Assessment.pdf Supplementary Document Uploaded 2024-12-17 Repair queued
Att E_Privacy Impact Assessment_DCIPHER SaaS.pdf Supplementary Document Uploaded 2024-12-17 Repair queued
Att E_Privacy Impact Assessment_DCIPHER SaaS.pdf Supplementary Document Uploaded 2024-12-17 Repair queued
Att D_Human Subjects Determination.pdf Supplementary Document Uploaded 2024-12-17 Available
Att D_Human Subjects Determination.pdf Supplementary Document Uploaded 2024-12-17 Repair queued
Att B_ Published Federal Register Notice.pdf Supplementary Document Uploaded 2024-12-17 Repair queued
Att B_ Published Federal Register Notice.pdf Supplementary Document Uploaded 2024-12-17 Repair queued
Att A_Section 301 of the Public Health Service Act (42 USC 241) (1) (1) (1).pdf Supplementary Document Uploaded 2024-12-17 Available
Att A_Section 301 of the Public Health Service Act (42 USC 241) (1) (1) (1).pdf Supplementary Document Uploaded 2024-12-17 Missing upstream
SSB_CryptoNet_2024 revision package - CLEAN.docx Supporting Statement B Uploaded 2024-12-17 Available
SSB_CryptoNet_2024 revision package - CLEAN.docx Supporting Statement B Uploaded 2024-12-17 Repair queued
SSA_CryptoNet_2024 revision package_CLEAN_final.docx Supporting Statement A Uploaded 2025-02-25 Available
SSA_CryptoNet_2024 revision package_CLEAN_final.docx Supporting Statement A Uploaded 2025-02-25 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
248663 CryptoNet Case Report Form Form and Instruction ModifiedCryptoNet Case Report Form (CRF)_REVISED 03APR2025
248663 CryptoNet Case Report Form Form and Instruction ModifiedCryptoNet Case Report Form
248663 CryptoNet Case Report Form Form and Instruction Modified
ICR Details
0920-1360 202504-0920-005
Active 202412-0920-011
HHS/CDC 0920-1360-25-0089
[NCEZID] CryptoNet Case Report Form
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 05/09/2025
Retrieve Notice of Action (NOA) 05/01/2025
  Inventory as of this Action Requested Previously Approved
02/29/2028 02/29/2028 02/29/2028
500 0 500
125 0 125
0 0 0

The goal of the CryptoNet Case Report Form (CRF) is to define a set of data elements that can be used to identify exposure trends in outbreak- and non-outbreak-associated Cryptosporidium cases, to generate hypotheses about the source(s) of infection in clusters or outbreaks, and to identify strategies to prevent and control cases, clusters, or outbreaks. This Revision includes race/ethnicity question modification and updating some laboratory test options. Non-Substantive Change Request is submitted to modify single question for compliance with EO 14168.

US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  89 FR 84144 10/21/2024
90 FR 1500 01/08/2025
No

1
IC Title Form No. Form Name
CryptoNet Case Report Form 0920-1360, n/a CryptoNet Case Report Form ,   CryptoNet Case Report Form (CRF)_REVISED 03APR2025

  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 500 500 0 0 0 0
Annual Time Burden (Hours) 125 125 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$12,719
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
No
Jeffrey Zirger 404 639-7118 [email protected]

  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.
05/01/2025