HAIC Multi-Site Gram-Negative Bacilli Case Report Form for Carbapenem-Resistant Pseudomonas ajeruginosa (CR-PA)

Emerging Infections Program

OMB: 0920-0978

IC ID: 230870

Information Collection (IC) Details

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HAIC Multi-Site Gram-Negative Bacilli Case Report Form for Carbapenem-Resistant Pseudomonas ajeruginosa (CR-PA)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0978 Carbapenem-resistant Pseudomonas aeruginosa Multi-Site Gram-Negative Surveillance (MuGSI) Case Report 21- MuGSI - CR-PA CRF_FINAL.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 3,440 0 3,440 0 0 0
Annual IC Time Burden (Hours) 2,580 0 2,580 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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