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
Coordination with TB Treating Physician/Foreign Health Authority in New Country
Unchanged
2610
435
10279
Form and Instruction
n/a
Telephone Script for Clinician/Foreign Health Authority Referral Follow-up
Cure TB Contact Source Investigation (CI/SI) Notification - LHD
Unchanged
100
50
2230
Form and Instruction
n/a
CureTB Contact/Source Investigation (CI/SI) Notification
Cure TB Transnational Notification - Referral from Local Health Departments
Unchanged
280
140
6244
Form and Instruction
n/a
CureTB Transnational Notification
CureTB Partner Feedback (at completion of referred patient's treatment)
New
50
5
223
Form and Instruction
n/a
CureTB Partner Feedback
Other-Questionnaire annotated with skip logic
CureTB Partner Feedback (at time of patient referral)
New
100
17
743
Form and Instruction
n/a
CureTB Partner Feedback
Other-Questionnaire annotated with skip logic
Individual Followup with Tuberculosis (TB) Patients Referred by ICE
Unchanged
587
440
10997
Form and Instruction
n/a
CureTB Transnational Notificaiton
Individual Followup with Tuberculosis (TB) Patients Referred by LHD
Unchanged
187
16
389
Form and Instruction
n/a
CureTB Transnational Notification
Total burden requested under this ICR:
3914
1103
31105
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