57.210 Healthcare Worker Prophylaxis/Treatment - Influenza

[NCEZID] The National Healthcare Safety Network (NHSN)

OMB: 0920-0666

IC ID: 183550

Information Collection (IC) Details

View Information Collection (IC)

57.210 Healthcare Worker Prophylaxis/Treatment - Influenza 0920-0666
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CDC 57.210 HCW Prophylaxis/Treatment-Influenza 57.210_HCWFluMedAdmin_BLANK.docx Yes Yes Fillable Fileable

Health Health Care Services

 

50 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   10 %

  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 2,500 0 0 0 0 2,500
Annual IC Time Burden (Hours) 417 0 0 0 0 417
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att G12_Healthcare Personnel Exposure G12. Healthcare Personnel Exposure.pdf 07/25/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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