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Federal forms, ICRs, and supporting documents

Information Collection

Post-discharge Hospital Patients with MRSA (Case Patients) - Screening and Consent Process

IC 205888 under ICR 201302-0920-016 · OMB 0920-0958.

Documents and Forms
Document Name
Document Type
Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Post-discharge Hospital Patients with MRSA (Case Patients) - Screening and Consent Process
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Attachment F-Screening questions HACO_revised 3_cleaned.docx Yes Yes Printable Only

Health Immunization Management

 

150 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 150 0 150 0 0 0
Annual IC Time Burden (Hours) 13 0 13 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment E - Verbal Consent.revised docx Attachment E - Verbal Consent.revised docx.docx 02/14/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.