View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Serious adverse events, including deaths, of unknown etiology following ceftriaxone administration among patients in multiple healthcare facility types, AL and multiple states, September 2024-Present 0920-1011-25-0118
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1011 N/A Yes Yes Paper Only

Disaster Management Emergency Response

 

90 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 120 0 120 0 0 0
Annual IC Time Burden (Hours) 60 0 60 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
0920-1011 EEI GenIC Request Memo 05/12/2025
0920-1011 EEI Burden Memo 05/12/2025
Non-Research Determination 05/12/2025
Alabama DOH - Letter of Invitation_Extension 05/12/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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