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Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents (.csv)

IC 270310 under ICR 202501-0920-003 · OMB 0920-1317.

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

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Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents (.csv) 0920-1317
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 57.216 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents 57.216 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

167 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved 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 8,684 0 0 0 0 8,684
Annual IC Time Burden (Hours) 8,973 0 0 0 0 8,973
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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