Form 0920-1317 VA COVID-19 Resident Event Form

[NCEZID] National Healthcare Safety Network (NHSN) Coronavirus (COVID-19) Surveillance in Healthcare Facilities

Clean 10.1.4 COVID 19 event reporting_resident form revised_7.22

VA - Resident COVID-19 Event Form - LTCF

OMB: 0920-1317

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-1317 can be found here:

2024-10-30 - Revision of a currently approved collection

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