Health Breach Notification Rule

ICR 202305-3084-001

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 3084-0150 can be found here:

Forms and Documents

Document Name	Status
Form Not Applicable Major Breaches Form and Instruction	Unchanged
Form Not Applicable Single-person Breaches Form and Instruction	Unchanged
Health Breach Notification Rule - 2023 Supporting Statement - Final.pdf Supporting Statement A	2023-06-07

IC Document Collections

IC ID	Document Title	Status
260390	Notice to Consumers (Non-Labor Costs for Breaches without Forensic Services)	New
260389	Notice to Consumers (Non-Labor Costs for Breaches that include Forensic Services)	New
235941	Major Breaches Form and Instruction	Unchanged
188848	Single-person Breaches Form and Instruction	Unchanged

ICR Details