Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Att K Human Infection with Novel Influenza A Virus Case Report Form Modified 342 171 0 Form none Human Infection with Novel Influenza A Virus Case Report Form
Form None Human Infection with Novel Influenza A Virus Case Report Form
Att AA_ Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements Modified 2548 212 0 Other-Variables for Electronic Reporting
Att BB_ Influenza Virus Electronic year round PHIN-MS Modified 156 13 0 Other-Variables for Reporting
Att D_Foodborne Disease Transmission Person-to-Person_Animal Contact Modified 1728 576 0 Form and Instruction CDC 52.13 National Outbreak Reporting System
Att E_WHO Collaborating Center for Influenza Virus Surveillance Internet Year Round Modified 1820 303 0 Form CDC 55.31 WHO Collaborating Center for Influenza Virus Surveillance (Internet: Year Round)
Att F US WHO Colloborating Laboratories Influenza Testing Methods Assessment Modified 87 15 0 Form CDC 55.31A US WHO Collaborating Laboratories Flu Testing Methods Assessment
Att G US Outpatient Influenza-like Illness Surveillance Network (ILINet) Weekly Modified 93600 15600 0 Form CDC 55.20 US Outpatient Influenza-like Illness Surveillance Network (ILINet) Weekly
Att I_ US Outpatient Influenza-like Illiness Surveillance Network (ILINet) Daily Reports Modified 27375 4563 0 Form None US Outpatient Influenza like Illness Surveillance Network (ILINet) Daily Reports
Att J_Influenza Associated Pediatric Mortality Case Report Form Modified 114 57 0 Form None Influenza Associated Pediatric Mortality Case Report Form
Att L Human Infection with Novel Influenza A Virus with Suspected Avian Source New 57 29 0 Form None Human Infection with Novel Influenza A Virus with Suspected Avian Source
Att M Human Infections with Novel Influenza A Virus Severe Outcomes New 57 86 0 Form None Human Infection with Novel Influenza A Virus Severe Outcomes
Att N Novel Influenza A Virus Infection Contact Tracing Form Modified 57 29 0 Form None Novel Influenza A Virus Infection Contact Tracing Form
Att O_Novel Influenza A Virus Status Case Status Summary Modified 57 14 0 Form None Novel Influenza A Virus Case Status Summary
Att P Novel Influenza A Virus Case Screening Form Modified 57 14 0 Form None Novel Influenza A Virus Case Screening Form
Att Q_122 CMRS - City Health Officer or Vital Statistics Registrars Daily Mortality Report Modified 21170 4234 0 Form CDC 43.50 122 CMRS -City Health Officers or Vital Statistics Registrars Daily Mortality Report
Att R_CMRS - City Health Officer or Vital Statistics Registrars Weekly Mortality Report Modified 6344 1269 0 Form none CMRS Weekly
Form CDC 43.5 122 CMRS-City Health Officers or Vital Statistics Registrars Weekly Mortality Report
Att S_Aggregate Hospitalization and Death Reporting Activity Weekly Report Form Modified 2912 485 0 Form none Aggregate Hospital
Att T Antiviral Resistant Influenza Infection Case Report Form New 171 86 0 Form None Antiviral Resistant Influenza Infection Case Report Form
Att U_National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment Modified 15600 3900 0 Form CDC 55.83 National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment
Form CDC 55.83A NREVSS Antigen Detection Worksheet
Form CDC 55.83D NREVSS Polymerase Chain Reaction (PCR) Worksheet
Form CDC 55.83B NREVSS Virus Isolation (culture) Worksheet
Att V_ National Enterovirus Surveillance Report 55.9 Modified 300 75 0 Form CDC 55.90 Enterovirus Surveillance System Report Form
Att W Adenovirus Typing Report Form New 300 75 0 Form None Adenovirus Typing Report Form
Att X Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form New 171 71 0 Form None Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form
Att Y_ Form for Submitting Specimens from Suspected Norovirus Outbreak Modified 100 25 0 Form None Form for Submitting Specimens from Suspected Norovirus Outbreaks
Att Z_ Waterborne Diseases Transmission Modified 57 19 0 Form and Instruction CDC 52.12 National Outbreak Reporting System: Waterborne Disease Transmission
Daily Influenza-like Illness Oct - May Removed 0 0 0 Form none Influenza-like Illness Daily and year round
HABISS Removed 0 0 0 Form No number HABISS
HABISS Monthly Reporting Form Removed 0 0 0 Form No Number HABISS Report
Influenza Virus Fax Oct-May 55.31 Removed 0 0 0 Form Influenza Fax WHO Fax Form
Influenza virus Internet Oct - May 55.31 Removed 0 0 0 Form none WHO Electronic
Influenza virus fax year-round 55.31 Removed 0 0 0 Form none WHO Fax Form
Novel and Pandemic Influenza A Virus Infection Contact Trace Back Form Removed 0 0 0 Form none Influenza A Trace Back
Weekly Influenza-like Illness Oct - May 55.20 Removed 0 0 0 Form 55.20 Weekly Influenza-like Illness
Total burden requested under this ICR: 175180 31921 0  
To view an IC, click on IC Title