Information Collection

57.155 Point of Care Testing Results - Manual

IC 266012 under ICR 202410-0920-012 · OMB 0920-1317.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1317 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 57.155 57.155 Point of Care Testing Results - Manual	Form and Instruction
57.155 Point of Care Testing Results 57.155_Point of Care Testing V14-Clean.docx	Form and Instruction
57.155 Point of Care Testing Results 57.155_Point of Care Testing V14-Clean.docx	Form and Instruction

IC Title:

57.155 Point of Care Testing Results - Manual

Agency IC Tracking Number:

57.155

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	57.155	Point of Care Testing Results	57.155_Point of Care Testing V14-Clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,135

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	470,250	0	470,250
Annual IC Time Burden (Hours)	94,050	15,675	78,375
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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