Information Collection

FluSurv-NET Laboratory Survey

IC 235052 under ICR 202604-0920-003 · OMB 0920-0978.

Documents and Forms

Document Name Document Type
Form FSN.300.4 FluSurv-NET Laboratory Survey FluSurv-NET Laboratory Survey Form
FSN.300.4 FluSurv-NET Laboratory Survey FSN.300.4_2026-27 FluSurv-NET Lab Survey_Final.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FluSurv-NET Laboratory Survey	Agency IC Tracking Number:	0920-0978

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 301 PHSA

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FSN.300.4	FluSurv-NET Laboratory Survey	FSN.300.4_2026-27 FluSurv-NET Lab Survey_Final.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	252	12	240
Annual IC Time Burden (Hours)	34	-6	40
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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