Pre-Training Infection Prevention and Safety Assessment

Reducing Healthcare Associated Infections (HAI): Improving patient safety through implementing multi-disciplinary interventions

Documents and Forms

Document Name Document Type
Form Form #1 Pre-Training Infection Prevention and Safety Assessment Form
Form #1 Pre-Training Infection Prevention and Safety Assessment Attachment B -- Pre-training Infection Prevention & Safety Assessment Instrument.doc Form

Information Collection (IC) Details

IC Title:	Pre-Training Infection Prevention and Safety Assessment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form #1	Pre-Training Infection Prevention and Safety Assessment	Attachment B -- Pre-training Infection Prevention & Safety Assessment Instrument.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 34	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	680	680
Annual IC Time Burden (Hours)	340	340
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.