OMB control number

[NCEZID] CryptoNet Case Report Form

OMB 0920-1360 · HHS/CDC.

OMB 0920-1360

The goal of the CryptoNet Case Report Form (CRF) is to define a set of data elements that can be used to identify exposure trends in outbreak- and non-outbreak-associated Cryptosporidium cases, to generate hypotheses about the source(s) of infection in clusters or outbreaks, and to identify strategies to prevent and control cases, clusters, or outbreaks. This Revision includes race/ethnicity question modification and updating some laboratory test options. Non-Substantive Change Request is submitted to modify single question for compliance with EO 14168.

The latest form for [NCEZID] CryptoNet Case Report Form expires 2028-02-29 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
CryptoNet Case Report Form Form and Instruction
CryptoNet Case Report Form Form and Instruction
Change Request Memo - EO14168 Template_CryptoNet_3.27.2025_FINAL.docx Justification for No Material/Nonsubstantive Change
Change Request Memo - EO14168 Template_CryptoNet_3.27.2025_FINAL.docx Justification for No Material/Nonsubstantive Change
Att E2_Privacy Impact Assessment.pdf Supplementary Document
Att E2_Privacy Impact Assessment.pdf Supplementary Document
Att E_Privacy Impact Assessment_DCIPHER SaaS.pdf Supplementary Document
Att E_Privacy Impact Assessment_DCIPHER SaaS.pdf Supplementary Document
Att D_Human Subjects Determination.pdf Supplementary Document
Att D_Human Subjects Determination.pdf Supplementary Document
Att B_ Published Federal Register Notice.pdf Supplementary Document
Att B_ Published Federal Register Notice.pdf Supplementary Document
Att A_Section 301 of the Public Health Service Act (42 USC 241) (1) (1) (1).pdf Supplementary Document
Att A_Section 301 of the Public Health Service Act (42 USC 241) (1) (1) (1).pdf Supplementary Document
SSB_CryptoNet_2024 revision package - CLEAN.docx Supporting Statement B
SSB_CryptoNet_2024 revision package - CLEAN.docx Supporting Statement B
SSA_CryptoNet_2024 revision package_CLEAN_final.docx Supporting Statement A
SSA_CryptoNet_2024 revision package_CLEAN_final.docx Supporting Statement A
CryptoNet Case Report Form Form and Instruction
CryptoNet Case Report Form Form and Instruction

All Historical Document Collections

202504-0920-005	No material or nonsubstantive change to a currently approved collection	2025-05-01
202412-0920-011	Revision of a currently approved collection	2025-01-10
202106-0920-015 Approved without change	New collection (Request for a new OMB Control Number)	2021-08-02