Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Ill Persons Adverse Outcome Form 1 part A New 750 125 0 Form and Instruction n/a Form 1 Medical Tourism Case Intake Form
Ill Persons Adverse Outcome Form 2 New 500 250 0 Form and Instruction n/a Form 2 Medical Tourism Enhanced Form
State and Local HD Staff Form 1 part B New 750 63 0 Form and Instruction n/a Form 1 Medical Tourism Case Intake Form
Total burden requested under this ICR: 2000 438 0  
To view an IC, click on IC Title