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Federal forms, ICRs, and supporting documents

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Antibiotic Prescription Data Template_Antibiotic Use Cohort

IC 258926 under ICR 202407-0935-001 · OMB 0935-0265.

Documents and Forms
Document Name
Document Type
Other-database
Other-database
IC Document
IC Document
Information Collection (IC) Details

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Antibiotic Prescription Data Template_Antibiotic Use Cohort
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-database Attachment G Antibiotic Prescription Data Template- Antibiotic Use Cohort (updated).xlsx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

225 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 4,050 0 1,350 0 0 2,700
Annual IC Time Burden (Hours) 4,050 0 1,350 0 0 2,700
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Instructions for Antibiotic Prescription Data Template_Antibiotic Stewardship Cohort Att L_Instructions for Anitbiotic Prescription Data Template_Antibiotic Stewardship Cohort.docx 03/06/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.