National Surveillance of Dialysis-Associated Diseases in

ICR 200010-0920-004

OMB: 0920-0033

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
37717
Migrated
ICR Details
0920-0033 200010-0920-004
Historical Active 199908-0920-001
HHS/CDC
National Surveillance of Dialysis-Associated Diseases in
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 10/16/2000
Retrieve Notice of Action (NOA) 10/16/2000
  Inventory as of this Action Requested Previously Approved
11/30/2002 11/30/2002 09/30/2002
3,200 0 3,200
3,200 0 3,200
0 0 0

The purpose of this data collection is to determine the frequency with which certain hemodialysis practices, including measures designed to prevent disease, are used; to determine the frequency of hemodialysis-associated complications and diseases; and to use this information to suggest further measures to prevent complications and disease in hemodialysis patients and staff. All chronic hemodialysis centers licensed by the Health Care Financing Administration are asked to participate.

None
None


No

1
IC Title Form No. Form Name
National Surveillance of Dialysis-Associated Diseases in

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,200 3,200 0 0 0 0
Annual Time Burden (Hours) 3,200 3,200 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/16/2000


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