Information Collection

CUSP Device Rounds

IC 275882 under ICR 202506-0935-002 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3 CUSP Device Rounds	Form and Instruction
Form 3 CLABSI Monthly Device Rounds Checklist CUSP Device Rounds	Form and Instruction
Form 3 CAUTI Monthly Device Rounds Checklist CUSP Device Rounds	Form and Instruction
Form 3 VAP VAE Monthly Device Rounds Checklist CUSP Device Rounds	Form and Instruction
3 CLABSI Monthly Device Rounds Checklist Attachment C - CLABSI Monthly Device Rounds Checklist.docx	Form and Instruction
3 CLABSI Monthly Device Rounds Checklist Attachment C - CLABSI Monthly Device Rounds Checklist.docx	Form and Instruction
3 CAUTI Monthly Device Rounds Checklist Attachment D - CAUTI Monthly Device Rounds Checklist.docx	Form and Instruction
3 CAUTI Monthly Device Rounds Checklist Attachment D - CAUTI Monthly Device Rounds Checklist.docx	Form and Instruction
3 VAP VAE Monthly Device Rounds Checklist Attachment E - VAP VAE Monthly Device Rounds Checklist.docx	Form and Instruction
3 VAP VAE Monthly Device Rounds Checklist Attachment E - VAP VAE Monthly Device Rounds Checklist.docx	Form and Instruction

IC Title:

CUSP Device Rounds

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3	Yes	Yes	Fillable Fileable
Form and Instruction	3	Yes	Yes	Fillable Fileable
Form and Instruction	3	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

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: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	900	900
Annual IC Time Burden (Hours)	1,350	1,350
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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