Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Assessment of Healthcare Personnel Exposed to or Infected with SARS-CoV-2 Modified 4000 2133 0 Form and Instruction 0920-20MZ
Form and Instruction 0920-1296
Form and Instruction 0920-1296
EIP or State Health Dept Employee Unchanged 120 10 0 Form and Instruction 0920-20MZ
Occupational Health Nurses at Healthcare Facilities (no form) Unchanged 1200 300 0 Form 0920-20MZ
Occupational Health Nurses at Healthcare Facilities -Assessment of Healthcare Personnel Exposed to or Infected with SARS-CoV-2: Denominator Form New 300 100 0 Form and Instruction 0920-1296
Total burden requested under this ICR: 5620 2543 0  
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