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57.101 Hospital Respiratory Data Form (Weekly - User Entry)

IC 269863 under ICR 202408-0920-011 · OMB 0920-1317.

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

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57.101 Hospital Respiratory Data Form (Weekly - User Entry)
 
No Unchanged
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1317 Hospital Respiratory Data Weekly Reporting Form 57.101 Hospital Respiratory Data Form - Weekly Reporting - Clean Version.docx N/A Yes Yes Fillable Fileable

Health Public Health Monitoring

 

1,148 0
   
Private Sector 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 59,696 0 0 0 0 59,696
Annual IC Time Burden (Hours) 200,977 0 0 0 0 200,977
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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