TeleTracking (TT) - U.S. HealthCare COVID-19 Portal

National Healthcare Safety Network (NHSN) Patient Impact Module for Coronavirus (COVID-19) Surveillance in Healthcare Facilities

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1290 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-1290 TeleTracking (TT) - U.S. HealthCare COVID-19 Portal Form and Instruction
0920-1290 U.S. HealthCare COVID-19 Portal Revised Webform - TeleTracking.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	TeleTracking (TT) - U.S. HealthCare COVID-19 Portal	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1290	U.S. HealthCare COVID-19 Portal	Revised Webform - TeleTracking.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	90,000	90,000
Annual IC Time Burden (Hours)	45,000	45,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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