Information Collection

NHSN and Secure Access Management Services (SAMS) enrollment

IC 243698 under ICR 202105-0920-014 · OMB 0920-1317.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1317 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-20LW NHSN and Secure Access Management Services (SAMS) enrollment Form and Instruction
0920-20LW NHSN Registration Form NHSN registration form.docx Form and Instruction
0920-20LW NHSN Registration Form NHSN registration form.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NHSN and Secure Access Management Services (SAMS) enrollment	Agency IC Tracking Number:	0920-20LW

Is this a Common Form? No		IC Status: Unchanged

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 and Instruction	0920-20LW	NHSN Registration Form	NHSN registration form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,500	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	11,500	11,500
Annual IC Time Burden (Hours)	11,500	11,500
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.