Information Collection

MRSA Infection Control Practices Survey

IC 182820 under ICR 200903-0920-009 · OMB 0920-0772.

Documents and Forms

Document Name Document Type
Form No Number MRSA Infection Control Practices Survey Form and Instruction
No Number MRSA Infection Control Practices Survey Attachment E MRSA Infection Control Practices Survey.doc Form and Instruction
Attachment 5 - proposed survey_EIP-ABC version.doc Attachment 5 - Revised questionnaire IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	MRSA Infection Control Practices Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	No Number	MRSA Infection Control Practices Survey	Attachment E MRSA Infection Control Practices Survey.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 210	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	210	210
Annual IC Time Burden (Hours)	105	105
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 5 - Revised questionnaire	Attachment 5 - proposed survey_EIP-ABC version.doc	03/23/2009

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