Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Documentation of information of deaths related to 2 point soft wrist restaints New 2556 426 0
Submission of Form New 1981 491 0 Form and Instruction CMS-10455 Screenshots of Electronic Submission
Training Modified 6389 6389 0 Form and Instruction CMS-10455 Health Death Report Form
Instruction
Total burden requested under this ICR: 10926 7306 0  
To view an IC, click on IC Title