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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ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form 0920-0978-18AXU
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 17AHK Att. 2 - ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form_HiNSES Att. 2 - ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form_HiNSES.pdf Yes Yes Fillable Printable
Form and Instruction 0920-0978 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Att 2- ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form_HiN....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 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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