Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Multistate outbreak of coccidioidomycosis (Valley fever) in U.S. students and adults who traveled to Tijuana area, Mexico New 45 15 0 Form and Instruction 0920-1011 Patient Screening Questionnaire
Multistate outbreak of coccidioidomycosis (Valley fever) in U.S. students and adults who traveled to Tijuana area, Mexico Unchanged 130 43 0 Form and Instruction 0920-1011 Questionnaire - Valley Fever
Undetermined risk factors for long term sequela resulting from Rocky Mountain spotted fever-Arizona, 2018 Unchanged 375 126 0 Form and Instruction 0920-1011 Patient Screening Questionnaire
Form and Instruction 0920-1011 Neurologial Examination Form
Undetermined risk factors for long term sequela resulting from Rocky Mountain spotted fever-Arizona, 2018 New 1 1 0 Form and Instruction 0920-1011 Patient Screening Questionnaire
Form and Instruction 0920-1011 Neurologic Exam Form
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 551 185 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title