AUR Pharmacy Data Electronic Upload Specification Tables (Initial Set-up)

[NCEZID] The National Healthcare Safety Network (NHSN)

Documents and Forms

Document Name Document Type
Form 57.124 AUR Pharmacy Data Electronic Upload Specification Tables (Initial Set-up) Form
57.124 Initial Set-up (form not used) 57.124 Initial Set-up.docx Form
57.124 (AUR)-Pharmacy Data Electronic Upload Specification Tables-Clean Version.docx Form Information only IC Document

Information Collection (IC) Details

IC Title:	AUR Pharmacy Data Electronic Upload Specification Tables (Initial Set-up)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	57.124	Initial Set-up (form not used)	57.124 Initial Set-up.docx		No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,500	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 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	60,000	60,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Form Information only	57.124 (AUR)-Pharmacy Data Electronic Upload Specification Tables-Clean Version.docx	11/04/2024

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