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57.701 - Glycemic Control Module-HYPO Annual Survey
[NCEZID] The National Healthcare Safety Network (NHSN)
OMB: 0920-0666
IC ID: 263468
OMB.report
HHS/CDC
OMB 0920-0666
ICR 202310-0920-013
IC 263468
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0666 can be found here:
2024-02-28 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 57.701
57.701 - Glycemic Control Module-HYPO Annual Survey
Form and Instruction
57.701 Glycemic Control module Hypo-Annual Hospital Survey
57.701 Glycemic Control Module Hypo-Annual Hospital Survey.docx
Form and Instruction
57.701 Glycemic Control module Hypo-Annual Hospital Survey
57.701 Glycemic Control Module Hypo-Annual Hospital Survey.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
57.701 - Glycemic Control Module-HYPO Annual Survey
Agency IC Tracking Number:
0920-0666
Is this a Common Form?
No
IC Status:
New
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
Form and Instruction
57.701
Glycemic Control module Hypo-Annual Hospital Survey
57.701 Glycemic Control Module Hypo-Annual Hospital Survey.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
10
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
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
10
0
10
0
0
0
Annual IC Time Burden (Hours)
20
0
20
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
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.