PRA IC List
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Agenda
Reg Review
ICR
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
Unchanged
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
Unchanged
2548
212
0
Other-Variables for Electronic Reporting
Att BB_ Influenza Virus Electronic year round PHIN-MS
Unchanged
156
13
0
Other-Variables for Reporting
Att D_Foodborne Disease Transmission Person-to-Person_Animal Contact
Modified
1998
666
0
Form
CDC 52.13
NORS - Foodborne, Person-to-Person, Animal Contact, Environmental Contamination, Unknown Transmission Mode
Att E_WHO Collaborating Center for Influenza Virus Surveillance Internet Year Round
Unchanged
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
Unchanged
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
Unchanged
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
Unchanged
27375
4563
0
Form
None
US Outpatient Influenza like Illness Surveillance Network (ILINet) Daily Reports
Att J_Influenza Associated Pediatric Mortality Case Report Form
Unchanged
114
57
0
Form
none
Influenza-Associated Pediatric Mortality Case Report
Att L Human Infection with Novel Influenza A Virus with Suspected Avian Source
Unchanged
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
Unchanged
57
86
0
Form
None
Human Infection with Novel Influenza A Virus Severe Outcomes
Att N Novel Influenza A Virus Infection Contact Tracing Form
Unchanged
57
29
0
Form
None
Novel Influenza A Virus Infection Contact Tracing Form
Att O_Novel Influenza A Virus Status Case Status Summary
Unchanged
57
14
0
Form
None
Novel Influenza A Virus Case Status Summary
Att P Novel Influenza A Virus Case Screening Form
Unchanged
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
Unchanged
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
Unchanged
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
Unchanged
2912
485
0
Form
none
Aggregate Hospital
Att T Antiviral Resistant Influenza Infection Case Report Form
Unchanged
171
86
0
Form
none
Antiviral-Resistant Influenza Infection Case Report
Att U_National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment
Unchanged
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
Unchanged
300
75
0
Form
CDC 55.90
Enterovirus Surveillance System Report Form
Att W Adenovirus Typing Report Form
Unchanged
300
75
0
Form
None
Adenovirus Typing Report Form
Att X Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form
Unchanged
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
Unchanged
100
25
0
Form
None
Form for Submitting Specimens from Suspected Norovirus Outbreaks
Att Z_ Waterborne Diseases Transmission
Modified
59
20
0
Form
CDC 52.12
NORS - Waterborne Disease Transmission
Total burden requested under this ICR:
175452
32012
0
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