VIM-Carbapenem Resistant Pseudomonas aeruginosa (VIM-CRPA) Outbreak Investigation Abstraction Form

Emergency Epidemic Investigation Data Collections

OMB: 0920-1011

IC ID: 257566

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VIM-Carbapenem Resistant Pseudomonas aeruginosa (VIM-CRPA) Outbreak Investigation Abstraction Form 0920-1011-23BT
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-1011 Chart Abstraction Form Appendix 1_VIM_CRPA_chart_abstraction_final.docx NA Yes Yes Fillable Fileable
Form 0920-1011 Facility Product List Appendix 2_ Facility_product_list_VIM-CRPA.xlsx NA Yes Yes Fillable Fileable

Disaster Management Emergency Response

Epidemic Investigation Case Records - SORN number 09-20-0113  51 FR 42466

30 0
   
State, Local, and Tribal Governments
 
   50 %

  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 105 0 105 0 0 0
Annual IC Time Burden (Hours) 105 0 105 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CSTE Letter of Support/Invitation CSTE letter of support_PseudomonasAeruginosa2022.pdf 12/22/2022
0920-1011 Burden Memo 0920-1011 GenIC Burden Memo.msg 12/22/2022
0929-1011 GenIC Request Memo 2023001-XXX VIM-CRPA_multistate.docx 12/22/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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