MRSA Infection Control Practices Survey - Illinois

Methicillin-Resistant Staphylococcus aureus (MRSA) Infection Control Practices Survey

Documents and Forms

Document Name Document Type
Form No number MRSA Infection Control Practices Survey - Illinois Form
No number Survey for Illinois Infection Control Practitioners Attachment 6 - proposed survey_Illinois.doc Form

Information Collection (IC) Details

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

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	No number	Survey for Illinois Infection Control Practitioners	Attachment 6 - proposed survey_Illinois.doc		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 188	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	188	188
Annual IC Time Burden (Hours)	94	94
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.