Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
57.101 Hospital Respiratory Data Form (Weekly - .csv import) Unchanged 179088 86559 0 Form and Instruction 0920-1317 Hospital Respiratory Data Weekly Reporting Form
57.101 Hospital Respiratory Data Form (Weekly - API) Unchanged 92872 23218 0 Form and Instruction 0920-1317 Hospital Respiratory Data Weekly Reporting Form
57.101 Hospital Respiratory Data Form (Weekly - User Entry) Unchanged 59696 200977 0 Form and Instruction 0920-1317 Hospital Respiratory Data Weekly Reporting Form
57.102 - Hospital Respiratory Data Fomr (Daily - API) Unchanged 279225 69806 0 Form and Instruction 57.102 Hospital Respiratory Data Daily Reporting Form 14AUG2024
57.102 - Hospital Respiratory Data Form (Daily - user entry) Unchanged 179580 173594 0 Form and Instruction 57.102 Hospital Respiratory Data Daily Reporting Form 14AUG2024
57.102 Hospital Respiratory Data Form (Daily - .csv import) Unchanged 538740 260391 0 Form and Instruction 57.102 Hospital Respiratory Data Daily Reporting Form 14AUG2024
57.140 NHSN and Secure Access Management Services (SAMS) enrollment Unchanged 11500 958 0 Form and Instruction 0920-1317 NHSN Registration Form
57.155 Point of Care Testing Results - CSV Unchanged 470250 94050 0 Form and Instruction 57.155 Point of Care Testing Results
57.155 Point of Care Testing Results - Manual Unchanged 470250 94050 0 Form and Instruction 57.155 Point of Care Testing Results
57.509 Weekly Patient COVID-19 Vaccination Cumulative Summary for Dialysis Facilities-.CSV Unchanged 33624 22416 0 Form and Instruction 57.509 57.509 Weekly COVID-19 Vaccination Cumulative Summary for Dialysis Patients_CSV
57.509 Weekly Patient COVID-19 Vaccination Cumulative Summary for Dialysis Facilities_Manual Unchanged 1284 963 0 Form and Instruction 57.509 Weekly COVID-19 Vaccination Cumulative Summary for Dialysis Patients_Manual
57.510 COVID–19 Module Dialysis Outpatient Facility-CSV Unchanged 6000 1000 0 Form and Instruction 57.510 57.510 COVID–19 Module Dialysis Outpatient Facility-.csv
57.510 COVID–19 Module Dialysis Outpatient Facility_Manual Unchanged 6000 2000 0 Form and Instruction 57.510 COVID–19 Module - Dialysis Outpatient Facility
Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel (.csv) Modified 1548 1548 0 Form and Instruction 57.217 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel
Form and Instruction 57.217 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel 29SEP2025
Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel (manual) Modified 13908 13908 0 Form and Instruction 57.217 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel
Form and Instruction 57.217 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel_29SEP2025
Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents (.csv) Modified 6188 6188 0 Form and Instruction 57.216 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents
Form and Instruction 57.216 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents Form 57.216_rev 29SEP2025
Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents (manual) Modified 55692 55692 0 Form and Instruction 57.216 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents
Form and Instruction 57.216 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents Form 57.216_rev 29SEP2025
Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary (.csv) Modified 90012 60008 0 Form and Instruction 57.219 Healthcare Personnel COVID-19 Vaccination Cumulative Summary
Form and Instruction 57.219 57.219 Healthcare Personnel COVID-19 Vaccination Cumulative Summary_25SEP2025
Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary (manual) Modified 159936 119952 0 Form and Instruction 57.219 Healthcare Personnel COVID-19 Vaccination Cumulative Summary
Form and Instruction 57.219 57.219 Healthcare Personnel COVID-19 Vaccination Cumulative Summary
Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities (.csv) Modified 84864 28288 0 Form and Instruction 57.218 Weekly Respiratory Pathogen and Vaccination Summary for Residents of Long-Term Care Facilities
Form and Instruction 57.218 Weekly Respiratory Pathogen and Vaccination Summary for Residents of LTCF (.csv)
Form and Instruction 57.218 57.218 Weekly Respiratory Pathogen and Vaccination Summary for Residents of LTCF_25SEP2025
Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities (manual) Modified 582764 242818 0 Form and Instruction Form 57.218 Weekly Respiratory Pathogen and Vaccination Summary for Residents of Long-Term Care Facilities (manual)
Form and Instruction 57.218 Weekly Respiratory Pathogen and Vaccination Summary for Residents of LTCF (manual)
Form and Instruction 57.218 57.218 Weekly Respiratory Pathogen and Vaccination Summary for Residents of LTCF_25SEP2025
Total burden requested under this ICR: 3323021 1558384 0  
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