Pathogens of High Consequence

[NCEZID] The National Healthcare Safety Network (NHSN)

Documents and Forms

Document Name Document Type
Form 57.130 Pathogens of High Consequence Form and Instruction
57.130 Pathogens of High Consequence 57.130_Pathogens of High Consequence Form.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Pathogens of High Consequence	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 and Instruction	57.130	Pathogens of High Consequence	57.130_Pathogens of High Consequence Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,650	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	1,332,250	1,332,250
Annual IC Time Burden (Hours)	666,125	666,125
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.