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Single-person Breaches
Health Breach Notification Rule
OMB: 3084-0150
IC ID: 188848
OMB.report
FTC
OMB 3084-0150
ICR 202305-3084-001
IC 188848
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3084-0150 can be found here:
2024-05-30 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Not Applicable
Single-person Breaches
Form and Instruction
Not Applicable Notice of Breach of Health Information
Health Breach Notification Rule Form.pdf
www.ftc.gov/system/files/documents/rules/health-breach-notification-rule/r2911002_hbn_092015.pdf
Form and Instruction
Information Collection (IC) Details
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