Healthcare Personnel Safety Monthly Reporting Plan - completed by Dialysis Facilities

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

OMB: 0920-1317

IC ID: 249438

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Healthcare Personnel Safety Monthly Reporting Plan - completed by Dialysis 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

 

7,700 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 69,300 0 0 0 0 69,300
Annual IC Time Burden (Hours) 5,775 0 0 0 0 5,775
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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