(MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report

[NCEZID] Emerging Infections Program

OMB: 0920-0978

IC ID: 217336

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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(MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report 0920-0978
 
No Modified
 
Voluntary
 
42 CFR 301 PHSA

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction HAIC 400.1 2024 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report_rev 2025 HAIC.400.1. MuGSI CRF 2024 (508c)_UPDATED2025.pdf N/A Yes Yes Fillable Fileable
Form and Instruction HAIC 400.1 2025 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report _rev 2025 HAIC.400.1 MuGSI CRF 2025 (508c)_UPDATED2025.pdf N/A Yes Yes Fillable Fileable
Form and Instruction HAIC 400.1 HAIC.400.1 Multi-Site Gram-Negative Surveillance Initiative (MuGSI) Case Report Form - 2026 HAIC.400.1 - MuGSI CRF 2026.pdf N/A Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

11 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested 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 17,391 0 0 0 0 17,391
Annual IC Time Burden (Hours) 8,406 0 0 0 0 8,406
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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