HAIC CDI Case Report Form

Emerging Infections Program

OMB: 0920-0978

IC ID: 217334

Information Collection (IC) Details

View Information Collection (IC)

HAIC CDI Case Report Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0978 Clostridium Difficile Infection (CDI) Surveillance Emerging Infections Program Case Report 16- ClostridiumDifficile-Form_v3.pdf NA 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 16,500 0 0 0 0 16,500
Annual IC Time Burden (Hours) 8,250 0 0 0 0 8,250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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