Information Collection

MRSA Infection Control Practices Survey

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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.