Form FSN.300.2 FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW

[NCEZID] Emerging Infections Program

FSN.300.2 Phone Script and Consent Form

FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish)

OMB: 0920-0978

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0978 can be found here:

2025-06-03 - No material or nonsubstantive change to a currently approved collection
2025-05-01 - No material or nonsubstantive change to a currently approved collection

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