57.305 Hemovigilance Incident

[NCEZID] The National Healthcare Safety Network (NHSN)

OMB: 0920-0666

IC ID: 190364

Information Collection (IC) Details

View Information Collection (IC)

57.305 Hemovigilance Incident
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CDC 57.305 Hemovigilance Module Incident 57.305_HV Incident_BLANK.docx Yes Yes Fillable Fileable

Health Health Care Services

 

500 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested 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 5,000 0 0 0 0 5,000
Annual IC Time Burden (Hours) 833 0 0 0 0 833
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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