OMB control number
[NCEZID] School-Based Active Surveillance (SBAS) of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Among Schoolchildren: Phase-2 of the National Roll-Out
OMB 0920-1396 · HHS/CDC.
The purpose of this submission is to request OMB authorization for a new information collection, “School-Based Active Surveillance (SBAS) of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Among Schoolchildren: Phase-2 of the National Roll-Out.” We are requesting three years to complete the information/data collection. This request is to expand the previous phase (Phase-1) that was under OMB Control No. 0920-1154. The new request is for Phase-2 of the project to field test and refine data collection tools and methods for determining the frequency of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) among other currently monitored chronic health conditions associated with school absenteeism and school withdrawal among US schoolchildren (grades kindergarten through twelve, K-12). Collection of information on better-known conditions that school nurses have already been tracking, in addition to ME/CFS, will allow assessment of the quality of this surveillance approach.
The latest form for [NCEZID] School-Based Active Surveillance (SBAS) of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Among Schoolchildren: Phase-2 of the National Roll-Out expires 2026-04-30 and can be found here.
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Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Supplementary Document |
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Supporting Statement B |
Supporting Statement A |
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Approved without change |
New collection (Request for a new OMB Control Number) | 2022-12-13 |
Electronic Platform Quarterly Chronic Absenteeism Data Reporting Form
Federal Enterprise Architecture: Health - Public Health Monitoring
| Form 0920-22HN | Electronic Platform Quarterly Chronic Absenteeism Data Reporting Form | Fillable Fileable | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.