Information Collection

57.207 Follow-up Laboratory Testing

IC 183557 under ICR 201211-0920-005 · OMB 0920-0666.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0666 can be found here:

Documents and Forms

Document Name Document Type
57.207_LabTesting_BLANK.docx Other-WORD
7. Healthcare Personnel Safety Component (IC#s 3, 9, 16, 34, 35, 36, 38).pdf Att G.7 HPSC IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	57.207 Follow-up Laboratory Testing	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
Other-WORD			57.207_LabTesting_BLANK.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	100	-59,900	60,000
Annual IC Time Burden (Hours)	1,250	-13,750	15,000
Annual IC Cost Burden (Dollars)	22,200	22,200	0

Documents for IC

Title	Document	Date Uploaded
Att G.7 HPSC	7. Healthcare Personnel Safety Component (IC#s 3, 9, 16, 34, 35, 36, 38).pdf	10/15/2012

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