Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2023 Active Bacterial Core Surveillance (ABCs) Case Report Modified 8090 2697 0 Form and Instruction 0920-0978 2023 Active Bacterial Core Surveillance (ABCs) Case Report
ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Unchanged 60 10 0 Form and Instruction 0920-0978 ABC H. Influenzae Neonatal Sepsis Expanded Surveillance Form
ABCs Invasive Pneumococcal Disease in Children Unchanged 1270 212 0 Form and Instruction 0920-0978 ABC Invasive Pneumococcal Disease in Children (age>2 months to <5 years
ABCs Severe GAS Infection Supplemental Form Unchanged 1360 453 0 Form and Instruction 0920-0978 ABC Severe GAS Infection Supplemental Form
Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form Modified 370 123 0 Form and Instruction 0920-0978 Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form
Community-Associated CP-CRE Interview Unchanged 100 50 0 Form and Instruction 0920-0978 CA CP-CRE Survey Questionnaire
Flu Surv NET Laboratory Survey Modified 160 26 0 Form 0920-0978 FluSurv-NET Laboratory Survey 2022-2023 Season
FoodNet Campylobacter Modified 9700 3395 0 Other-Variable list
FoodNet Cyclospora Modified 420 70 0 Other-Variable list
FoodNet Hemolytic Uremic Syndrome (HUS) Modified 100 100 0 Form and Instruction 0920-0978 FoodNet CDC's FoodNet Hemolytic Uremic syndrome (HUS) Surveillance Case Report Form
FoodNet Listeria monocytogenes Modified 160 53 0 Other-Variable list
FoodNet Salmonella Modified 8550 2993 0 Other-Variable list
FoodNet Shiga toxin producing E. coli Modified 2900 967 0 Other-Variable list
FoodNet Shigella Modified 2340 390 0 Other-Variable list
FoodNet Vibrio Modified 460 77 0 Other-Variable list
FoodNet Yersinia Modified 550 92 0 Other-Variable list
Foodnet Clinical Laboratory Practices and Testing Volume Modified 700 233 0 Form and Instruction 0920-0978 FoodNET Clinical Lab Practices and Testing Volume
HAIC CDI Annual Laboratory Survey Modified 160 51 0 Form and Instruction 0920-0978 Annual Survey of Laboratory Testing Practices for C. difficile Infection (Clostridioides difficile Infection (CDI) Surveillance)
HAIC CDI Annual Surveillance Officers Survey Modified 10 3 0 Form and Instruction 0920-0978 Surveillance Officer's Survey (Clostridioides difficile Infection (CDI) Surveillance)
HAIC CDI Case Report Form Modified 16500 10450 0 Form and Instruction 0920-0978 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT
HAIC CDI LTCF Survey Unchanged 450 38 0 Form and Instruction 0920-0978 Emerging Infections Progrom C. difficile Surveillance Nuring Home Telephone Call Survey
HAIC Candidemia Case Report Form Modified 1700 1134 0 Form and Instruction 0920-0978 Candidemia 2023 Case Report
HAIC Candidemia Periodic Laboratory Survey Modified 200 43 0 Form and Instruction 0920-0978 2023 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE
HAIC Death Ascertainment Project Unchanged 80 1920 0 Form and Instruction 0920-0978 Death Ascertainment Project Variables
HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA) Modified 5840 2725 0 Form and Instruction 0920-0978 Invasive Methicillin-Resistant Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2023
HAIC Invasive Methicillin-resistant Staphylococcus aureus (MRSA) Modified 3400 1587 0 Form and Instruction 0920-0978 Invasive Methicillin-Resistant Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2023
HAIC Invasive Staphylococcus aureus Annual Laboratory Survey Modified 110 37 0 Form and Instruction 0920-0978 CDC’s Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus Laboratory Survey
HAIC Invasive Staphylococcus aureus Annual Surveillance Officers Survey Modified 10 2 0 Form and Instruction 0920-0978 2022 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey
HAIC Multi-Site Gram-Negative Bacilli Case Report Form (MuGSI-CRE/CRAB) Modified 5000 2333 0 Form 0920-0978 2023 Carbapenem Resistant Enterobacteriaceae (CRE)/ Carbapenem resistant A. baumannii (CRAB) MuGSI HAIC Case Report HAIC Case Report Form
HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL) Modified 42000 17500 0 Form 0920-0978 2023 MuGSI Extended-Spectrum Beta-Lactamase (ESBL)-Producing Enterobacteriaceae/Omvasove Escjerocjoa coli (MuGSI) (HAIC) Case Report
HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey Unchanged 10 3 0 Form and Instruction 0920-0978 MuGSI SO Survey Questionnaire
Influenza Hospitalization Surveilance Network Case Report Form Modified 9770 3183 0 Form and Instruction 0920-0978 2022-23 FluSurv-NET Influenza Hospitalization Surveillance Project Case Report Form
Influenza Hospitalization Surveillance Project Provider Vaccination History Fax Form (Children/Adults) Unchanged 3330 278 0 Form and Instruction 0920-0978 FluSurv Net Provider Vaccination History Fax Form
Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English) Unchanged 3330 278 0 Form and Instruction 0920-0978 FluSurv NET Vaccination Phone Script
Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (Spanish) Unchanged 3330 278 0 Form and Instruction 0920-0978 FluSurv NET Vaccination Phone Script
Total burden requested under this ICR: 132520 53784 0  
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