Hospitals (excluding Psychiatric and Rehabilitation Hospitals)

Unified Hospital Data Surveillance System (U.S. Healthcare COVID-19 Collection)

Documents and Forms

Document Name Document Type
0990-0478 U.S. Healthcare COVID-19 Portal _ New Entry - 29Nov21.pdf Other-portal
0990-0478 U.S. Healthcare COVID-19 Portal _ New Entry - 29Nov21.pdf Other-portal
New-Entry-Guidance Updates_Final.pdf Other-portal
New-Entry-Guidance Updates_Final.pdf Other-portal

Information Collection (IC) Details

IC Title:	Hospitals (excluding Psychiatric and Rehabilitation Hospitals)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-portal			0990-0478 U.S. Healthcare COVID-19 Portal _ New Entry - 29Nov21.pdf		Yes	Yes	Fillable Fileable
Other-portal			New-Entry-Guidance Updates_Final.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,898,000	0	1,898,000
Annual IC Time Burden (Hours)	2,087,800	-284,700	2,372,500
Annual IC Cost Burden (Dollars)	0	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.