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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
Modified
114
57
0
Form
NA
Human Infection with Novel Influenza A Virus Case Report Form (addition of Suspected Avian Source)
Att AA_ Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements
Modified
2964
247
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_NORS Foodborne Disease Transmission_ Person to Person Disease Transmission_Animal Contact_Environmental Contamination_Unknown Transmission Mode
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
Modified
2756
459
0
Form
NA
WHO Collaborating Center for Influenza Virus Surveillance
Att F US WHO Colloborating Laboratories Influenza Testing Methods Assessment
Modified
113
19
0
Form
NA
WHO Collaborating Laboratories Influenza 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
Removed
0
0
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
NA
Influenza-Associated Pediatric Mortality Case Report
Att L Human Infection with Novel Influenza A Virus with Suspected Avian Source
Removed
0
0
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
Removed
0
0
0
Form
None
Novel Influenza A Virus Infection Contact Tracing Form
Att O_Novel Influenza A Virus Status Case Status Summary
Removed
0
0
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
Removed
0
0
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
Removed
0
0
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
Removed
0
0
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
Modified
28600
7150
0
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
240
60
0
Form
CDC 55.90
Enterovirus Surveillance System Report Form
Att W Adenovirus Typing Report Form
Modified
52
13
0
Form
NA
National Adenovirus Type Reporting System (NATRS) Form
Att X Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form
Modified
171
71
0
Form
None
Middle East Respiratory Syndrome (MERS) Patient Under Investigation (PUI) Short Form
Att Y_ Viral Gastroenteritis Outbreak Submission Form
Modified
100
8
0
Form
None
Viral Gastroenteritis Outbreak Submission Form
Att Z_ Waterborne Diseases Transmission
Modified
59
20
0
Form
CDC 52.12
NORS - Waterborne Disease Transmission
Att. CC Suspect Respiratory Virus Patient Form
New
50
25
0
Form
NA
Suspect Respiratory Virus Patient Form
Att. H U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) Workfolder_CDC 55.20E
New
1800
150
0
Form
CDC 55.20E
U.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet) - Workfolder_CDC 55.20E
Total burden requested under this ICR:
133172
24801
0
To view an IC, click on IC Title