Information Collection

Dialysis Facility Infection Preventionists - NHSN New Facility Enrollment

IC 244456 under ICR 202011-0920-005 · OMB 0920-1306.

Documents and Forms

Document Name Document Type
Dialysis Facility Infection Preventionists - NHSN New Facility Enrollment Form
NHSN Registration Form NHSN registration form.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Dialysis Facility Infection Preventionists - NHSN New Facility Enrollment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NA	NHSN Registration Form	NHSN registration form.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 700	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8,400	8,400
Annual IC Time Burden (Hours)	700	700
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.