Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2024 Active Bacterial Core Surveillance (ABCs) Case Report Modified 8090 2697 0 Form and Instruction CDC 52.12A REV 2019
ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Unchanged 60 10 0 Form and Instruction 0920-0978
ABCs Invasive Pneumococcal Disease in Children and Adults Modified 1270 212 0 Form and Instruction CDC 52.15A REV.8-2023
ABCs Severe GAS Infection Supplemental Form Unchanged 1360 453 0 Form and Instruction 0920-0978
Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form Unchanged 370 123 0 Form and Instruction 0920-0978
Flu Surv NET Laboratory Survey Modified 240 40 0 Form CS341327-A 7/31/2023
FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form Modified 10905 4544 0 Form and Instruction CS340190-A
FluSurv-Net Influenza Hospitalization Surveillance Project Provider Vaccination History Fax Form (Children/Adults) Modified 1764 147 0 Form and Instruction 0920-0978-24BX
FluSurv-Net Influenza Hospitalization Surveillance Project Vaccination Phone Script and Consent Form (English/Spanish) Modified 224 37 0 Form and Instruction 0920-0978-24BX
FoodNet Campylobacter Modified 9700 3395 0 Other-Variable list
FoodNet Cyclospora Modified 420 70 0 Other-Variable list
FoodNet Hemolytic Uremic Syndrome (HUS) Unchanged 100 100 0 Form and Instruction 0920-0978
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 700 117 0 Other-Variable List 2024
HAIC - CDI Case Report and Treatment Form Modified 16500 10450 0 Form and Instruction CS 342179-A 8/3/2023
HAIC Candidemia Case Report Form Modified 1700 1133 0 Form and Instruction Short Form 2024
HAIC Death Ascertainment Project Unchanged 80 1920 0 Form and Instruction 0920-0978
HAIC Invasive Methicillin-resistant Staphylococcus aureus (MRSA) Removed 0 0 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 10 2 0 Form and Instruction 0920-0978
HAIC Invasive Staphylococcus aureus Case Report – 2024 Modified 7880 3677 0 Form and Instruction CDC 52.15B Rev.07-2019
HAIC MuGSI CA CP-CRE Health interview Modified 100 50 0 Form and Instruction 0920-0978
HAIC Multi-Site Gram-Negative Surveillance Initiative (MUGSI) Case Report Form Modified 47000 21933 0 Form CS342262-A 9/20/2023
HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL) Removed 0 0 0 Form 0920-0978
HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey Unchanged 10 3 0 Form and Instruction 0920-0978
HAIC- Annual Survey of Laboratory Testing Practices for C. difficile Infections Modified 160 45 0 Form and Instruction 0920-0978
HAIC- CDI Annual Surveillance Officers Survey Modified 10 3 0 Form and Instruction 0920-0978
HAIC- EIP C. difficile Surveillance Nursing Home Telephone Survey (LTCF) Modified 450 38 0 Form and Instruction 0920-0978
HAIC- Laboratory Testing Practices for Candidemia Questionnaire Modified 200 47 0 Form and Instruction 2024
Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (Spanish) Unchanged 3330 278 0 Form and Instruction 0920-0978
Total burden requested under this ICR: 127703 56133 0  
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