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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Cruise Ship General Outcome Reporting -Maritime (Word & Excel)
Removed
0
0
0
Form
none
General Reporting Maritime (Excel)
Form
none
General Reporting Maritime (Word)
Cruise Ship Measles Outcome Reporting - Maritime (Word & Excel)
Removed
0
0
0
Form
none
Measles Maritime (Word)
Form
none
Measles Maritime (Excel)
Cruise Ship Rubella Outcome Reporting - Maritime (Word & Excel)
Removed
0
0
0
Form
none
Rubella Maritime (Word)
Form
none
Rubella Maritime (Excel)
Cruise Ship TB Outcome Reporting - Maritime (Word)
Modified
15
5
187
Form
n/a
Clinically Active TB Contact Investigation Outcome Reporting Form - Maritime
Ebola Exposure Questionnaire for Airline Passengers
Removed
0
0
0
Form and Instruction
None
Ebola Exposure Questionnaire for Airline Passengers
Ebola Exposure Questionnaire for Airport Staff
Removed
0
0
0
Form and Instruction
None
Ebola Exposure Questionnaire for Airport Staff
Ebola Exposure Questionnaire for Cleaning Crew
Removed
0
0
0
Form and Instruction
None
Ebola Exposure Questionnaire for Cleaninig Crew
Ebola Exposure Questionnaire for Flight Crew
Removed
0
0
0
Form and Instruction
None
Ebola Exposure Questionnaire for Flight Crew
Ebola Exposure Questionnaire for Passengers on Other Commercial Conveyances
Removed
0
0
0
Form and Instruction
None
Ebola Exposure Questionnaire for Passengers of Other Commercial Conveyances
Influenza-like Illness Investigation Outcome Reporting Form - Maritime
New
45
15
561
Form
n/a
Influenza-like Illness Investigation Outcome Reporting Form
Script for DGMQ HotLine - Introduction
Removed
0
0
0
Form and Instruction
None
Script for DGMQ HotLine - Introduction, Flight and Seat Confirmation Ebola Air Contact Investigation
State/Local General Contact Reporting (Land)
Modified
15
1
47
Form
n/a
General Contact Investigation Outcome Reporting Form (Land)
State/Local General Outcome Reporting (Air)
Modified
34
3
106
Form
n/a
General Contact Investigation Outcome Reporting Form - Air
State/Local Measles Outcome Reporting (Air)
Modified
324
27
1008
Form
0920-0900
Measles Air Contact Investigation Outcome Reporting Form
Form
n/a
Measles Contact Investigation Outcome Reporting Form - Air
State/Local Rubella Outcome Reporting (Air)
Modified
27
2
84
Form
n/a
Rubella Contact Investigation Outcome Reporting Form - Air
State/Local TB Outcoming Reporting (Air)
Modified
547
46
1701
Form
n/a
TB Contact Investigation Outcome Reporting Form - Air
Varicella Investigation Outcome Reporting Form
New
29
10
361
Form
n/a
Varicella Investigation Outcome Reporting Form
Total burden requested under this ICR:
1036
109
4055
To view an IC, click on IC Title