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Weekly Healthcare Personnel Influenza Vaccination Cumulative Summary for Non-Long-Term Care Facilities

IC 246755 under ICR 202412-0920-018 · OMB 0920-0666.

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

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Weekly Healthcare Personnel Influenza Vaccination Cumulative Summary for Non-Long-Term Care Facilities 0920-0666
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CDC 57.211 Weekly HCP Influenza Vaccination Cumulative Summary Non-Long-Term Care Facilities 57.211 Healthcare Personnel Influenza Vaccination Cumulative Summary for Non-LTCF.docx NA Yes Yes Fillable Fileable

Health Health Care Services

 

117 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 1,404 0 0 0 0 1,404
Annual IC Time Burden (Hours) 585 0 0 0 0 585
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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