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Federal forms, ICRs, and supporting documents

Information Collection

[OADPS/NCEZID] HAI/IR Programs (2023-2025)

IC 261311 under ICR 202506-0920-009 · OMB 0920-1282.

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Information Collection (IC) Details

View Information Collection (IC)

[OADPS/NCEZID] HAI/IR Programs (2023-2025) 0920-25-0105
 
Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-1282 Form 1 - HAI/AR Response & Prevention Performance Measures PM1 - PM5 [NCEZID] - Data Reporting [Form 1] [revision 2024-2026] [03-17-2025].pdf NA Yes Yes Fillable Fileable
Form 0920-1282 Form 2-1 - HAI/AR Performance Measures (SHARP Project III; Antibiotic Stewardship [NCEZID] - Data Reporting [Form 2 - 1] [revision 2024-2026] [03-17-2025].pdf NA Yes Yes Fillable Fileable
Form 0920-1282 Form 3 - HAI/AR Performance Measures (SHARP Project IV; NHSN) [NCEZID] - Data Reporting [Form 3] [new 2023-2025] [07-26-2023].pdf NA Yes Yes Fillable Fileable
Form 0920-1282 Form 4 - HAI/AR Performance Measures (SHARP Project V; Project Firstline) [NCEZID] - Data Reporting [Form 4] [revision 2024-2026] [03-17-2025].pdf NA Yes Yes Fillable Fileable
Form 0920-1282 Form 5 - HAI/AR Program Staffing Directory [NCEZID] - Data Reporting [Form 5] [new 2023-2025] [07-26-2023].pdf NA Yes Yes Fillable Fileable
Form and Instruction n/a Form 2-2 - HAI/AR Performance Measures (SHARP Project III; Antibiotic Stewardship [NCEZID] - Data Reporting [Form 2 - 2] [revision 2024-2026] [03-17-2025].pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

336 0
   
State, Local, and Tribal Governments
 
   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 672 0 39 0 0 633
Annual IC Time Burden (Hours) 1,545 0 122 0 0 1,423
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
0920-1282 GenIC Request Template [NCEZID] - GenIC Request [new 2023-2025] [07-26-2023].pdf 07/31/2023
Funding Awards by Recipient [NCEZID] - Funding awards by recipient [new 2023-2025] [07-26-2023].docx 07/31/2023
REDCap Form - cover page [NCEZID] - REDCap form cover page [new 2023-2025] [07-26-2023].docx 07/31/2023
Sample Email [NCEZID] - Sample Email [new 2023-2025] [07-26-2023].docx 07/31/2023
Technical Specifications [NCEZID] - Technical specifications [new 2023-2025] [07-26-2023].docx 07/31/2023
GenIC Request Template Updated NCEZID - GenIC Request revision 2024-2026 03-17-2025_Updated_final.docx 06/17/2025
Change Request Justification Change-Memo-03 17 2025.docx 06/17/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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