Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
ABCs Case Report Form Unchanged 8090 2697 0 Form and Instruction 0920-0978
ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Unchanged 60 10 0 Form and Instruction 0920-0978
ABCs Invasive Pneumococcal Disease in Children Unchanged 220 37 0 Form and Instruction 0920-0978
ABCs Neonatal Infection Expanded Tracking Form Unchanged 370 123 0 Form and Instruction 0920-0978
ABCs Severe GAS Infection Supplemental Form Unchanged 1360 453 0 Form and Instruction 0920-0978
COVID-19 - CDI Case Report and Treatment Form Removed 0 0 0 Form and Instruction 0920-0978
COVID-19 - Invasive Methicillin-resistant Staphylococcus aureus (MRSA) Infection Case Report Form Removed 0 0 0 Form and Instruction 0920-0978
COVID-19 - Invasive Methicillin-sensitive Staphylococcus aureus (MSSA) Infection Case Report Form Removed 0 0 0 Form and Instruction 0920-0978
COVID-19 - MuGSI Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae (ESBL) Removed 0 0 0 Form and Instruction 0920-0978
COVID-19 - MuGSI Case Report Form for Carbapenem-resistant Enterobacteriaceae (CRE) and Acinetobacter baumannii (CRAB) Removed 0 0 0 Form and Instruction 0920-0978
Flu Surv NET Laboratory Survey Unchanged 230 38 0 Form and Instruction 0920-0978
FoodNet Campylobacter Unchanged 9420 3297 0 Form and Instruction 0920-0978
FoodNet Cyclospora Unchanged 1630 272 0 Form and Instruction 0920-0978
FoodNet Hemolytic Uremic Syndrome (HUS) Unchanged 100 100 0 Form and Instruction 0920-0978
FoodNet Listeria monocytogenes Unchanged 150 50 0 Form and Instruction 0920-0978
FoodNet Salmonella Unchanged 7890 2761 0 Form and Instruction 0920-0978
FoodNet Shiga toxin producing E. coli Unchanged 2050 683 0 Form and Instruction 0920-0978
FoodNet Shigella Unchanged 2130 355 0 Form and Instruction 0920-0978
FoodNet Vibrio Unchanged 340 56 0 Form and Instruction 0920-0978
FoodNet Yersinia Unchanged 480 80 0 Form and Instruction 0920-0978
Foodnet Clinical Laboratory Practices and Testing Volume Unchanged 700 233 0 Form and Instruction 0920-0978
HAIC CDI Annual Laboratory Survey Unchanged 160 40 0 Form and Instruction 0920-0978
HAIC CDI Annual Surveillance Officers Survey Unchanged 10 3 0 Form and Instruction 0920-0978
HAIC CDI Case Report Form Modified 16500 10450 0 Form and Instruction 0920-0978
HAIC CDI LTCF Survey Unchanged 450 38 0 Form and Instruction 0920-0978
HAIC Candidemia Case Report Form Unchanged 2000 1000 0 Form and Instruction 0920-0978
HAIC Candidemia Periodic Laboratory Survey Unchanged 135 45 0 Form and Instruction 0920-0978
HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA) Modified 5840 2725 0 Form and Instruction 0920-0978
HAIC Invasive Methicillin-resistant Staphylococcus aureus (MRSA) Modified 3400 1587 0 Form and Instruction 0920-0978
HAIC Invasive Staphylococcus aureus Annual Laboratory Survey Unchanged 110 37 0 Form and Instruction 0920-0978
HAIC Invasive Staphylococcus aureus Annual Surveillance Officers Survey Unchanged 100 17 0 Form and Instruction 0920-0978
HAIC Multi-Site Gram-Negative Bacilli Case Report Form (MuGSI-CRE/CRAB) Modified 5000 2333 0 Form and Instruction 0920-0978
HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL) Modified 11040 5152 0 Form and Instruction 0920-0978
Influenza Hospitalization Surveilance Network Case Report Form Unchanged 10000 4167 0 Form and Instruction 0920-0978
Influenza Hospitalization Surveillance Project Provider Vaccination History Fax Form (Children/Adults) Unchanged 3330 278 0 Form and Instruction 0920-0978
Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English) Unchanged 3330 278 0 Form and Instruction 0920-0978
Form and Instruction 0920-0978
Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (Spanish) Unchanged 3330 278 0 Form and Instruction 0920-0978
Form and Instruction 0920-0978
Total burden requested under this ICR: 99955 39673 0  
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