OMB control number

[NIOSH] National Disease Surveillance Program

OMB 0920-0009 · HHS/CDC.

OMB 0920-0009

The purpose of this data collection is to collect disease specific surveillance reports of rare, uncommon, or infrequent diseases. The data will be used to determine the prevalence of diseases dangerous to public health. The data will also be used for planning and evaluating effective programs for prevention and control of infectious diseases. Disease incidence is needed to study present and emerging disease problems. Case data will be transmitted to CDC electronically or hard copy from State and Local Health Departments. This Revision includes reduction of burden hours due to fewer respondents expected. Updates to the format for collecting race and ethnicity have been made to the acute flaccid myelitis data collection form and will be implemented once the package is approved. We seek to use the modified version of “Race and Ethnicity Question with Minimum Categories Only”.

The latest form for [NIOSH] National Disease Surveillance Program expires 2029-03-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-0009 Att D-4_Acute Flaccid Myelitis Form and Instruction
Form 0920-0009 Att D-3_Reye Syndrome Form and Instruction
Form 0920-0009 Att D2_Kawasaki Syndrome Form and Instruction
Form 0920-0009 Att D-1_CJD Form and Instruction
H. PIA CJD, Reye Syndrome, Kawasaki.pdf Supplementary Document
G. PIA AFM.pdf Supplementary Document
F. Standardized Case Definition for AFM.pdf Supplementary Document
E. Non-research determination.pdf Supplementary Document
C. Surveillance Summaries.docx Supplementary Document
B. Published 60-Day Federal Register 0920-0009.pdf Supplementary Document
A. Authorizing legislation.pdf Supplementary Document
H. PIA CJD, Reye Syndrome, Kawasaki.pdf Supplementary Document
G. PIA AFM.pdf Supplementary Document
F. Standardized Case Definition for AFM.pdf Supplementary Document
E. Non-research determination.pdf Supplementary Document
C. Surveillance Summaries.docx Supplementary Document
B. Published 60-day NDSP.pdf Supplementary Document
A. Authorizing legislation.docx Supplementary Document
SSB 0009 - 2025 Revision.docx Supporting Statement B
SSA 0009 - 2025 Revision.docx Supporting Statement A
Att D-4_Acute Flaccid Myelitis Form and Instruction
Att D-3_Reye Syndrome Form and Instruction
Att D2_Kawasaki Syndrome Form and Instruction
Att D-1_CJD Form and Instruction

All Historical Document Collections

202601-0920-004	Revision of a currently approved collection	2026-01-21
202208-0920-011 Approved without change	Revision of a currently approved collection	2022-08-26
202207-0920-013 Approved without change	No material or nonsubstantive change to a currently approved collection	2022-07-29
201912-0920-004 Approved without change	No material or nonsubstantive change to a currently approved collection	2019-12-09
201905-0920-011 Approved without change	Extension without change of a currently approved collection	2019-06-26
201901-0920-013 Approved without change	No material or nonsubstantive change to a currently approved collection	2019-02-01
201708-0920-015 Approved without change	No material or nonsubstantive change to a currently approved collection	2017-08-16
201601-0920-001 Approved with change	Revision of a currently approved collection	2016-01-11
201502-0920-003 Approved without change	No material or nonsubstantive change to a currently approved collection	2015-02-10
201410-0920-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2014-10-03
201401-0920-007 Approved without change	No material or nonsubstantive change to a currently approved collection	2014-01-28
201311-0920-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2013-11-05
201305-0920-010 Approved without change	No material or nonsubstantive change to a currently approved collection	2013-05-28
201303-0920-007 Approved without change	Revision of a currently approved collection	2013-03-14
201003-0920-010 Approved without change	Revision of a currently approved collection	2010-03-23
200906-0920-018 Approved without change	No material or nonsubstantive change to a currently approved collection	2009-06-19
200807-0920-006 Approved without change	No material or nonsubstantive change to a currently approved collection	2008-07-30
200707-0920-005 Approved without change	No material or nonsubstantive change to a currently approved collection	2007-07-25
200611-0920-008 Approved with change	Revision of a currently approved collection	2006-11-29
200307-0920-011 Approved without change	No material or nonsubstantive change to a currently approved collection	2003-07-29
200212-0920-008 Approved without change	Revision of a currently approved collection	2002-12-23
200104-0920-010 Approved without change	Extension without change of a currently approved collection	2001-04-30
199911-0920-001 Approved without change	Reinstatement with change of a previously approved collection	1999-11-19
199305-0920-002 Approved without change	Reinstatement with change of a previously approved collection	1993-05-20
199005-0920-005 Approved without change	Revision of a currently approved collection	1990-05-25
198910-0920-002 Approved without change	Revision of a currently approved collection	1989-10-11
198707-0920-003 Approved with change	No material or nonsubstantive change to a currently approved collection	1987-07-31
198609-0920-002 Approved without change	Revision of a currently approved collection	1986-09-03
198405-0920-001 Approved without change	Revision of a currently approved collection	1984-05-10
198309-0920-001 Approved without change	Revision of a currently approved collection	1983-09-23
198304-0920-001 Approved without change	Revision of a currently approved collection	1983-04-27
198104-0920-003 Approved without change	Revision of a currently approved collection	1981-04-24
198011-0920-004 Approved without change	Revision of a currently approved collection	1980-11-26
198005-0920-001 Approved without change	Revision of a currently approved collection	1980-05-15
197809-0920-002 Approved without change	Revision of a currently approved collection	1978-09-25
197706-0920-001 Approved with change	No material or nonsubstantive change to a currently approved collection	1977-06-28
197612-0920-001 Approved without change	Revision of a currently approved collection	1976-12-27
197610-0920-001 Approved without change	Revision of a currently approved collection	1976-10-07
197604-0920-001 Approved without change	Revision of a currently approved collection	1976-04-06
197603-0920-001 Approved with change	No material or nonsubstantive change to a currently approved collection	1976-03-24
197509-0920-001 Approved with change	No material or nonsubstantive change to a currently approved collection	1975-09-16
197409-0920-002 Approved without change	Revision of a currently approved collection	1974-09-30

OMB Details

Att D-1_CJD

Federal Enterprise Architecture: Health - Public Health Monitoring

Form 0920-0009

CJD form

Fillable Fileable

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.