OMB control number

Ebola Virus Disease in the United States:CDC Support for Case and Contact Investigation

OMB 0920-1045 · HHS/CDC.

OMB 0920-1045

Latest Forms, Documents, and Supporting Material

Document Name
EVD Contact Tracing Investigation Form Form and Instruction
EVD Case Investigation Form - United States Form and Instruction
White House Evening Report Form and Instruction
Symptom Monitoring Form - Environmental Lab Personnel Form and Instruction
EVD Tracking Form for Environmental Services Personnel Form and Instruction
Symptom Monitoring Form - Lab Personnel Form and Instruction
EVD Tracking Form for Laboratory Personnel Form and Instruction
Symptom Monitoring Form - Health Care Workers Form and Instruction
EVD Tracking Form for Healthcare Workers with Direct Patient Contact Form and Instruction
Symptom Monitoring Form Form and Instruction
Ebola Virus Disease Person Under Investigation (PUI) Form Form and Instruction
SupStmnt A US EVD CaseContInvest 20150123.docx Supporting Statement A
Appndx2b ASTHO cmmnts CDC response 14JAN2015.docx Supplementary Document
Appndx2a CSTE cmmnts CDC rsponse 14JAN2015.docx Supplementary Document
SupStmnt B US EVD CaseContInvest 20150123.docx Supporting Statement B
Att7 Generic End-of-Monitoring Letter.docx Supplementary Document
Att4b Info for HCWs Treating Ebola Patients.docx Supplementary Document
Att4a Guidance for Contacts of Ebola Patients.docx Supplementary Document
Att3cGuidance for Eval Triage of Ebola Contacts.docx Supplementary Document
Att3b Guidance for Eval Triage of Ebola Contacts.docx Supplementary Document
Att3a Guidance for HD DA-AM of Returned Travelers.docx Supplementary Document
Appndx3 SORN 09-20-0113 Epidemic Invest Case Records.pdf Supplementary Document
Appndx1 42 USC 241 PH Service Act Section 301.pdf Supplementary Document
Appndx2c_NACCHOcomments.docx Supplementary Document
EVD Contact Tracing Investigation Form Form and Instruction
EVD Case Investigation Form - United States Form and Instruction
White House Evening Report Form and Instruction
Symptom Monitoring Form - Environmental Lab Personnel Form and Instruction
EVD Tracking Form for Environmental Services Personnel Form and Instruction
Symptom Monitoring Form - Lab Personnel Form and Instruction
EVD Tracking Form for Laboratory Personnel Form and Instruction
Symptom Monitoring Form - Health Care Workers Form and Instruction
EVD Tracking Form for Healthcare Workers with Direct Patient Contact Form and Instruction
Symptom Monitoring Form Form and Instruction
Ebola Virus Disease Person Under Investigation (PUI) Form Form and Instruction

All Historical Document Collections

201501-0920-006

Approved with change

New collection (Request for a new OMB Control Number)

2015-01-14