Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Unchanged 60 10 0 Form and Instruction ABC.100.3 2019 ABC H. Influenzae Neonatal Sepsis Expanded Surveillance Form
2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey Unchanged 10 2 0 Form and Instruction HAIC.400.6 2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey
Form and Instruction HAIC 400.6 2024 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey
2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report Modified 17391 8406 0 Form and Instruction HAIC 400.1 2024 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report_rev 2025
Form and Instruction HAIC 400.1 2025 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report _rev 2025
2024 Active Bacterial Core Surveillance (ABCs) Case Report Unchanged 8090 2697 0 Form and Instruction ABC.100.1 2024 Active Bacterial Core Surveillance (ABCs) Case Report
Form and Instruction ABC 100.1 2025 Active Bacterial Core Surveillance (ABCs) Case Report
2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey Unchanged 11 4 0 Form and Instruction HAIC.400.3 2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey
ABCs Invasive Pneumococcal Disease in Children and Adults Unchanged 1270 212 0 Form and Instruction ABC.100.2 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN (aged ≥2 months to <5 years) AND ADULTS (aged ≥65 years)
Form and Instruction ABC 100.2 2025 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 ABC.100.4 ABCs Severe GAS Infection: Supplemental Form
Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form Unchanged 370 123 0 Form and Instruction ABC.100.5 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) NEONATAL INFECTION EXPANDED TRACKING FORM
Form and Instruction ABC 100.5 2025 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) NEONATAL INFECTION EXPANDED TRACKING FORM
Annual Survey of Laboratory Testing Practices for C. difficile Infection Unchanged 160 45 0 Form and Instruction HAIC.400.8 Annual Survey of Laboratory Testing Practices for C. difficile Infection
Form and Instruction HAIC 400.8 Annual Survey of Laboratory Testing Practices for C. difficile Infection
CANDIDEMIA 2024 CASE REPORT FORM Modified 1700 1133 0 Form and Instruction HAIC 400.11 CANDIDEMIA 2024 CASE REPORT FORM_rev 2025
Form and Instruction HAIC 400.11 CANDIDEMIA 2025 CASE REPORT FORM_rev 2025
CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey Unchanged 110 17 0 Form and Instruction HAIC.400.5 CDC’s Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey
CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT Modified 16500 10450 0 Form and Instruction HAIC 400.7 2024 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT_rev 2025
Form and Instruction HAIC 400.7 2025 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT_ rev 2025
Community-Associated CP-CRE Interview Unchanged 100 50 0 Form and Instruction HAIC.400.2 Community-Associated CP-CRE Interview
Data Elements Transferred to CDC for the HAIC Death Ascertainment Project Unchanged 80 1920 0 Form and Instruction HAIC.400.13 Data Elements Transferred to CDC for the HAIC Death Ascertainment Project
Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey Unchanged 450 38 0 Form and Instruction HAIC.400.10 Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey
FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish) Unchanged 208 34 0 Form and Instruction FSN.300.2 FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW
FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM Unchanged 1638 136 0 Form and Instruction FSN.300.3 FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM
FluSurv-NET Laboratory Survey 2023–2024 Season Unchanged 240 40 0 Form FSN.300.4 FluSurv-NET Laboratory Survey 2023–2024 Season
FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form Unchanged 8640 3600 0 Form and Instruction FSN.300.1 Influenza Hospitalizatin Surveillance Network (FluSurv-NET) Case Report Form
Form and Instruction FSN 300.1 2024-25 Influenza Hospitalization Surveillance Network (FluSurv-NET) Case Report Form
FoodNET Lab Survey Variable List 2024 Unchanged 700 117 0 Form FN.200.10 FoodNET Lab Survey Variable List, 2024
FoodNet Hemolytic Uremic Syndrome (HUS) Modified 100 100 0 Form and Instruction ABC 200.9 FoodNet CDC's FoodNet Hemolytic Uremic Syndrome (HUS) Surveillance Case Report Form_rev 2025
FoodNet Variable List, 2024_ (CYCLOSPORA) Unchanged 420 70 0 Form and Instruction FN.200.2 FoodNet Variable List, 2024_ (CYCLOSPORA)
Form and Instruction FN 200.2 FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES) Unchanged 160 53 0 Form and Instruction FN.200.3 FoodNet Variable List, 2024_ (LISTERIA MONOCYTOGENES)
Form and Instruction FN 200.3 FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (SALMONELLA) Unchanged 8550 2993 0 Form and Instruction FN.200.4 FoodNet Variable List, 2024_ (SALMONELLA)
Form and Instruction FN 200.4 FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI) Unchanged 2900 967 0 Form and Instruction FN.200.5 FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI)
Form and Instruction FN 200.5 FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (SHIGELLA) Unchanged 2340 390 0 Form and Instruction FN.200.6 FoodNet Variable List, 2024_ (SHIGELLA)
Form and Instruction FN 200.6 FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (VIBRIO) Unchanged 460 77 0 Form and Instruction FN.200.7 FoodNet Variable List, 2024_ (VIBRIO)
Form and Instruction FN 200.7 FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (YERSINIA) Unchanged 550 92 0 Form and Instruction FN.200.8 FoodNet Variable List, 2024_ (YERSINIA)
Form and Instruction FN 200.8 FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_(CAMPYLOBACTER) Unchanged 5500 1925 0 Form and Instruction FN.200.1 FoodNet Variable List, 2024_ (CAMPYLOBACTER)
Form and Instruction FN 200.1 FoodNet Variable List, (Site-transmitted variables) - 2025
HAIC-Surveillance Officer's Survey Unchanged 10 3 0 Form and Instruction HAIC.400.9 HAIC Surveillance Officer’s Survey
Form and Instruction HAIC 400.9 HAIC Surveillance Officer’s Survey
HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE Unchanged 200 47 0 Form and Instruction HAIC.400.12 2024 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE
Form and Instruction HAIC 400.12 2025 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE
Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report Modified 7880 3809 0 Form and Instruction HAIC 400.4 2024 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report_rev 2025
Form and Instruction HAIC 400.4 2025 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report_rev 2025
Form and Instruction HAIC 400.4 2022 Invasive Methicillin-Resistant Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report _rev 2025
Form and Instruction HAIC 400.4 2023 Invasive Methicillin-Resistant Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report _rev 2025
Form and Instruction HAIC 400.4 2022 Invasive Methicillin-Sensitive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report _rev 2025
Form and Instruction HAIC 400.4 2023 Invasive Methicillin-Sensitive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report _rev 2025
Total burden requested under this ICR: 88158 40013 0  
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