2015 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form

Emerging Infections Program

OMB: 0920-0978

IC ID: 220380

Information Collection (IC) Details

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2015 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form 16SA
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CDC 10-2015 2015 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Att. 3 - HiNSES Case Report Form.pdf Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

10 0
   
State, Local, and Tribal Governments
 
   100 %

  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 60 0 0 0 0 60
Annual IC Time Burden (Hours) 10 0 0 0 0 10
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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