Information Collection Request

[NCEZID] Information Collection for Tuberculosis Data from Referring Entities to CureTB

ICR 202402-0920-003 · OMB 0920-1186 · Received in OIRA

Forms and Documents

Document Name	Status
Form 0920-1186 CureTB Partner Feedback (Satsifaction Assessment) Questionnaire 2 Form and Instruction	Modified
Form 0920-1186 CureTB Partner Feedback (Satisfaction Assessment) Questionnaire 1 Form and Instruction	Modified
Form CS347315-A (02/01/ CureTB Transnational Notification (TB patients referred by ICE) Form and Instruction	Modified
Form 0920-1186 Telephone Script Clinician /Foreign Health Authority Follow-up (CureTB) Form and Instruction	Modified
Form CS347315-B (Revise CureTB Contact/Source Investigation (CI/SI) Notification (USHD - local & state) Form and Instruction	Modified
Form CS347315-A (02/01/ CureTB Transnational Notification (TB patients referred by USHD) Form and Instruction	Modified
Form CS347315-A (02/01/ Cure TB Transnational Notification (referral from LHDs) Form and Instruction	Modified
Att. J-CureTB Notification Email.pdf Supplementary Document	2024-02-21
Determination email to PIA (0920-1186).pdf Supplementary Document	2024-02-09
Att. I- CureTB-PIA-Signed.pdf Supplementary Document	2024-02-21
SSA_CureTB_022124_v2.docx Supporting Statement A	2024-02-21
Att. H- Human Subjects Determination.pdf Supplementary Document	2024-02-21
Att. B- Published 60-Day Federal Register Notice.pdf Supplementary Document	2024-02-09
Att. A5 - Section 311.pdf Supplementary Document	2020-06-08
Att. A4 - Section 301.pdf Supplementary Document	2020-06-08
Att. A3 - 42 CFR Part 71.pdf Supplementary Document	2020-06-08
Att. A2 - 42 CFR Part 70.pdf Supplementary Document	2020-06-08
Att. A1 - Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document	2020-06-08
Supporting Statement B_CureTB.docx Supporting Statement B	2024-02-21

IC Document Collections

IC ID	Document Title	Status
252225	CureTB Partner Feedback (Satsifaction Assessment) Questionnaire 2 Form and Instruction	Modified
252223	CureTB Partner Feedback (Satisfaction Assessment) Questionnaire 1 Form and Instruction	Modified
242057	CureTB Transnational Notification (TB patients referred by ICE) Form and Instruction	Modified
226739	Telephone Script Clinician /Foreign Health Authority Follow-up (CureTB) Form and Instruction	Modified
226738	CureTB Contact/Source Investigation (CI/SI) Notification (USHD - local & state) Form and Instruction	Modified
226737	CureTB Transnational Notification (TB patients referred by USHD) Form and Instruction	Modified
226736	Cure TB Transnational Notification (referral from LHDs) Form and Instruction	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CDC
OMB Control No	0920-1186
Type of Information Collection	Revision of a currently approved collection
Previous ICR Reference No	202203-0920-003
Agency Tracking No	0920-1186
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31