Health Breach Notification Rule

ICR 202403-3084-001

OMB: 3084-0150

Federal Form Document

Forms and Documents

Document Name	Status
Form Not Applicable Notice for Health Applications (Non-Labor Costs for Breaches without Forensic Services) Form and Instruction	Modified
Form Not Applicable Notice for Health Applications (Non-Labor Costs for Breaches that include Forensic Services) Form and Instruction	Modified
Form Not Applicable Major Breaches Form and Instruction	Modified
Form Not Applicable Single-person Breaches Form and Instruction	Modified
HBNR_2024_Supporting Statement_Final .pdf Supporting Statement A	2024-05-22

IC Document Collections

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