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FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish)
[NCEZID] Emerging Infections Program
OMB: 0920-0978
IC ID: 207653
OMB.report
HHS/CDC
OMB 0920-0978
ICR 202504-0920-028
IC 207653
( )
Documents and Forms
Document Name
Document Type
Form FSN.300.2
FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish)
Form and Instruction
FSN.300.2 FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW
FSN.300.2 Phone Script and Consent Form.pdf
Form and Instruction
Information Collection (IC) Details
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