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
CDC SAMPLE VHF Jurisdiction Final Survey
New
70
23
0
Form and Instruction
0920-25-0004
Attachment H - CDC SAMPLE VHF Jurisdiction Final Survey
CDC SAMPLE VHF Jurisdiction Traveler Monitoring
New
7280
607
0
Form and Instruction
0920-25-0004
Attachment G - CDC SAMPLE VHF Jurisdiction Traveler Monitoring
Inital Screening Form
New
54750
4563
0
Form
0920-25-0004
Attachment C - CDC Initial Screening Form_SAMPLE VHF
POE Public Health Risk Assessment Form
New
5475
1825
0
Form
0920-25-0004
Attachment D - POE Public Health Risk Assessment Form_SAMPLE VHF
SAMPLE VHF Response Survey of Travelers
New
5475
913
0
Form and Instruction
0920-25-0004
Attachment F - SAMPLE VHF Response Survey of Travelers
SAMPLE VHF Symptom Monitoring Daily Group Symptomatic Travelers
New
11508
192
0
Form
0920-25-0004
Attachment E1 - SAMPLE VHF Symptom Monitoring Daily Group
SAMPLE VHF Symptom Monitoring Web Survey
New
11508
958
0
Form and Instruction
0920-25-0004
Attachment E3 - SAMPLE VHF Symptom Monitoring Web Survey
SAMPLE VHF Symptom Monitoring Web Survey
New
12894
1232
0
Form and Instruction
0920-25-0004
Attachment E3 - SAMPLE VHF Symptom Monitoring Web Survey
Sample VHF Symptom Monitoring Weekly Group
New
14784
246
0
Form and Instruction
0920-25-0004
Attachment E2 - SAMPLE VHF Symptom Monitoring Weekly Group
Total burden requested under this ICR:
123744
10559
0
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