Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Cruise Ship General Outcome Reporting -Maritime (Word & Excel) Unchanged 200 17 0 Form none General Reporting Maritime (Excel)
Form none General Reporting Maritime (Word)
Cruise Ship Measles Outcome Reporting - Maritime (Word & Excel) Unchanged 126 11 0 Form none Measles Maritime (Word)
Form none Measles Maritime (Excel)
Cruise Ship Rubella Outcome Reporting - Maritime (Word & Excel) Unchanged 24 2 0 Form none Rubella Maritime (Word)
Form none Rubella Maritime (Excel)
Cruise Ship TB Outcome Reporting - Maritime (Word & Excel) Unchanged 300 25 0 Form none TB Maritime Word
Form none TB Maritime (Excel)
Ebola Exposure Questionnaire for Airline Passengers Unchanged 340 113 0 Form and Instruction None Ebola Exposure Questionnaire for Airline Passengers
Ebola Exposure Questionnaire for Airport Staff Unchanged 100 33 0 Form and Instruction None Ebola Exposure Questionnaire for Airport Staff
Ebola Exposure Questionnaire for Cleaning Crew Unchanged 120 40 0 Form and Instruction None Ebola Exposure Questionnaire for Cleaninig Crew
Ebola Exposure Questionnaire for Flight Crew Unchanged 240 80 0 Form and Instruction None Ebola Exposure Questionnaire for Flight Crew
Ebola Exposure Questionnaire for Passengers on Other Commercial Conveyances Unchanged 180 60 0 Form and Instruction None Ebola Exposure Questionnaire for Passengers of Other Commercial Conveyances
Script for DGMQ HotLine - Introduction Unchanged 2500 208 0 Form and Instruction None Script for DGMQ HotLine - Introduction, Flight and Seat Confirmation Ebola Air Contact Investigation
State/Local General Contact Reporting (Air) Modified 50 4 0 Form NA General Air Contact Investigation Outcome Reporting Form
State/Local General Outcome Reporting (Land) Unchanged 12 1 0 Form none General Contact Reporting (Land)
State/Local Measles Outcome Reporting (Air) Modified 964 80 0 Form NA Measles Air Contact Investigation Outcome Reporting Form
State/Local Rubella Outcome Reporting (Air) Modified 95 8 0 Form NA Rubella Air Contact Investigation Outcome Reporting Form
State/Local TB Outcoming Reporting (Air) Modified 1244 104 0 Form NA Tuberculosis Air Contact Investigation Outcome Reporting Form
Total burden requested under this ICR: 6495 786 0  
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