57.318_hv Ar-taco_blank

The National Healthcare Safety Network (NHSN)

OMB: 0920-0666

IC ID: 222905

Information Collection (IC) Details

View Information Collection (IC)

57.318_HV AR-TACO_BLANK 0920-0666
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 57.318 Hemoviligance Adverse Reaction - Transfusion Associated Circulatory Overload 57.318_HV AR-TACO_BLANK.DOCX Yes Yes Fillable Printable

Health Public Health Monitoring

 

500 0
   
Private Sector Businesses or other for-profits
 
   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 1,000 0 0 0 0 1,000
Annual IC Time Burden (Hours) 333 0 -84 0 0 417
Annual IC Cost Burden (Dollars) 11,663 0 11,663 0 0 0

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

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