PRA IC List
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Agenda
Reg Review
ICR
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
2024 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 and Adults
Modified
1270
212
0
Form and Instruction
CDC 52.15A REV.8-2023
ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN (aged ≥2 months to <5 years) AND ADULTS (aged ≥65 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
Unchanged
370
123
0
Form and Instruction
0920-0978
Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form
Flu Surv NET Laboratory Survey
Modified
240
40
0
Form
CS341327-A 7/31/2023
FluSurv-NET Laboratory Survey 2023–2024 Season
FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form
Modified
10905
4544
0
Form and Instruction
CS340190-A
2023-24 Influenza Hospitalization Surveillance Network (FluSurv-NET) Case Report Form
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 Provider Vaccination History Fax Form (Children/Adults)
FluSurv-Net Influenza Hospitalization Surveillance Project Vaccination Phone Script and Consent Form (English/Spanish)
Modified
224
37
0
Form and Instruction
0920-0978-24BX
FluSurv NET Vaccination Phone Script
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 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
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
CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT
HAIC Candidemia Case Report Form
Modified
1700
1133
0
Form and Instruction
Short Form 2024
CANDIDEMIA 2024 CASE REPORT FORM
HAIC Death Ascertainment Project
Unchanged
80
1920
0
Form and Instruction
0920-0978
Death Ascertainment Project Variables
HAIC Invasive Methicillin-resistant Staphylococcus aureus (MRSA)
Removed
0
0
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
Unchanged
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
Unchanged
10
2
0
Form and Instruction
0920-0978
2022 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey
HAIC Invasive Staphylococcus aureus Case Report – 2024
Modified
7880
3677
0
Form and Instruction
CDC 52.15B Rev.07-2019
Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2024
HAIC MuGSI CA CP-CRE Health interview
Modified
100
50
0
Form and Instruction
0920-0978
Community-Associated CP-CRE Interview
HAIC Multi-Site Gram-Negative Surveillance Initiative (MUGSI) Case Report Form
Modified
47000
21933
0
Form
CS342262-A 9/20/2023
2024 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report
HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL)
Removed
0
0
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
HAIC- Annual Survey of Laboratory Testing Practices for C. difficile Infections
Modified
160
45
0
Form and Instruction
0920-0978
Annual Survey of Laboratory Testing Practices for C. difficile Infection
HAIC- CDI Annual Surveillance Officers Survey
Modified
10
3
0
Form and Instruction
0920-0978
Surveillance Officer’s Survey CDC’s Emerging Infections Program Clostridioides difficile Infection (CDI) Surveillance
HAIC- EIP C. difficile Surveillance Nursing Home Telephone Survey (LTCF)
Modified
450
38
0
Form and Instruction
0920-0978
Emerging Infections Progrom C. difficile Surveillance Nuring Home Telephone Call Survey
HAIC- Laboratory Testing Practices for Candidemia Questionnaire
Modified
200
47
0
Form and Instruction
2024
2024 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE
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:
127703
56133
0
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