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Healthcare Personnel Safety Monthly Reporting Plan - completed by Inpatient Psychiatric Facilities

IC 249439 under ICR 202404-0920-010 · OMB 0920-1317.

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Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
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Healthcare Personnel Safety Monthly Reporting Plan - completed by Inpatient Psychiatric Facilities 0920-1317
 
No Unchanged
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CDC Form 57.203 Healthcare Personnel Safety Monthly Reporting Plan 57.203_HCPSafetyPlan_July2021_FINAL.docx NA Yes Yes Fillable Fileable

Health Public Health Monitoring

 

394 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 4,728 0 0 0 0 4,728
Annual IC Time Burden (Hours) 394 0 0 0 0 394
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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