View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Undetermined source, mode of transmission, and risk factors for Candida auris infection - Colombia, 2016 0920-1011-16BEG
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Case Report Form - English Appendix 1a - Data Collection Instrument_Colombia C. auris (English).doc NA No   Paper Only
Form and Instruction NA Case Report Form - Spanish Appendix 1b - Data Collection Instrument_Colombia C. auris (Spanish).doc NA No   Paper Only
Form and Instruction NA HealthCare Provider Interview Appendix 2 - Healthcare Interview Questions.doc NA No   Paper Only
Form and Instruction NA Patient Open-Ended Interview Appendix 3 - Patient Open-Ended Interviews.doc NA No   Paper Only

Health Illness Prevention

09-20-0113 - Epidemic Investigation Case Records  51 FR 42466

22 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 70 0 70 0 0 0
Annual IC Time Burden (Hours) 35 0 35 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Burden Request Memo - Email Burden Request Memo.msg 09/19/2016
Letter of Invitation Colombian Instituto Nacional de Salud - Candida Letter of Invite.pdf 09/19/2016
GenIC Request 1 GenIC Request Form - EEI Generic ICR_Colombia C auris.docx 09/19/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.