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Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel (.csv)

IC 270313 under ICR 202502-0920-015 · OMB 0920-1317.

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

View Information Collection (IC)

Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel (.csv) 0920-1317
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 57.217 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel 57.217 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel - Clean.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

106 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 5,512 0 0 0 0 5,512
Annual IC Time Burden (Hours) 5,696 0 0 0 0 5,696
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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