Form 0920-0978 COVID-19 - CDI Case Report and Treatment Form |
Form and Instruction |
Removed |
Repair queued |
Form 0920-0978 COVID-19 - Invasive Methicillin-sensitive Staphylococcus aureus (MSSA) Infection Case Report Form |
Form and Instruction |
Removed |
Repair queued |
Form 0920-0978 COVID-19 - Invasive Methicillin-resistant Staphylococcus aureus (MRSA) Infection Case Report Form |
Form and Instruction |
Removed |
Available |
Form 0920-0978 COVID-19 - MuGSI Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae (ESBL) |
Form and Instruction |
Removed |
Repair queued |
Form 0920-0978 COVID-19 - MuGSI Case Report Form for Carbapenem-resistant Enterobacteriaceae (CRE) and Acinetobacter baumannii (CRAB) |
Form and Instruction |
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Form 0920-0978 HAIC Candidemia Periodic Laboratory Survey |
Form and Instruction |
Unchanged |
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Form 0920-0978 HAIC Invasive Staphylococcus aureus Annual Surveillance Officers Survey |
Form and Instruction |
Unchanged |
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Form 0920-0978 HAIC Invasive Staphylococcus aureus Annual Laboratory Survey |
Form and Instruction |
Unchanged |
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Form 0920-0978 HAIC CDI LTCF Survey |
Form and Instruction |
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Form 0920-0978 HAIC CDI Annual Surveillance Officers Survey |
Form and Instruction |
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Form 0920-0978 HAIC CDI Annual Laboratory Survey |
Form and Instruction |
Unchanged |
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Form 0920-0978 Flu Surv NET Laboratory Survey |
Form and Instruction |
Unchanged |
Available |
Form 0920-0978 Foodnet Clinical Laboratory Practices and Testing Volume |
Form and Instruction |
Unchanged |
Available |
Form 0920-0978 HAIC Candidemia Case Report Form |
Form and Instruction |
Unchanged |
Repair queued |
Form 0920-0978 HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA) |
Form and Instruction |
Modified |
Repair queued |
Form 0920-0978 HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL) |
Form and Instruction |
Modified |
Available |
Form 0920-0978 Influenza Hospitalization Surveillance Project Provider Vaccination History Fax Form (Children/Adults) |
Form and Instruction |
Unchanged |
Available |
Form 0920-0978 Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (Spanish) |
Form and Instruction |
Unchanged |
Repair queued |
Form 0920-0978 ABCs Severe GAS Infection Supplemental Form |
Form and Instruction |
Unchanged |
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Form 0920-0978 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form |
Form and Instruction |
Unchanged |
Repair queued |
Form 0920-0978 HAIC Multi-Site Gram-Negative Bacilli Case Report Form (MuGSI-CRE/CRAB) |
Form and Instruction |
Modified |
Available |
Form 0920-0978 HAIC CDI Case Report Form |
Form and Instruction |
Modified |
Repair queued |
Form 0920-0978 FoodNet Yersinia |
Form and Instruction |
Unchanged |
Repair queued |
Form 0920-0978 FoodNet Vibrio |
Form and Instruction |
Unchanged |
Available |
Form 0920-0978 FoodNet Shigella |
Form and Instruction |
Unchanged |
Available |
Form 0920-0978 FoodNet Shiga toxin producing E. coli |
Form and Instruction |
Unchanged |
Repair queued |
Form 0920-0978 FoodNet Salmonella |
Form and Instruction |
Unchanged |
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Form 0920-0978 FoodNet Listeria monocytogenes |
Form and Instruction |
Unchanged |
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Form 0920-0978 FoodNet Cyclospora |
Form and Instruction |
Unchanged |
Repair queued |
Form 0920-0978 FoodNet Campylobacter |
Form and Instruction |
Unchanged |
Available |
Form 0920-0978 Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English) |
Form and Instruction |
Unchanged |
Repair queued |
Form 0920-0978 FoodNet Hemolytic Uremic Syndrome (HUS) |
Form and Instruction |
Unchanged |
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Form 0920-0978 Influenza Hospitalization Surveilance Network Case Report Form |
Form and Instruction |
Unchanged |
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Form 0920-0978 ABCs Neonatal Infection Expanded Tracking Form |
Form and Instruction |
Unchanged |
Repair queued |
Form 0920-0978 ABCs Invasive Pneumococcal Disease in Children |
Form and Instruction |
Unchanged |
Available |
Form 0920-0978 HAIC Invasive Methicillin-resistant Staphylococcus aureus (MRSA) |
Form and Instruction |
Modified |
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Form 0920-0978 ABCs Case Report Form |
Form and Instruction |
Unchanged |
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0920-0978 Change Memo - EIP HAIC COVID-19 CRF additions_updated07242020_CLEAN.docx |
Justification for No Material/Nonsubstantive Change |
Uploaded 2020-07-29 |
Repair queued |
0920-0978 Change Memo - EIP HAIC COVID-19 CRF additions.docx |
Justification for No Material/Nonsubstantive Change |
Uploaded 2020-06-24 |
Available |
Att24_Cross walk.pdf |
Supplementary Document |
Uploaded 2019-12-10 |
Repair queued |
Att23_Description of Changes.pdf |
Supplementary Document |
Uploaded 2019-12-10 |
Available |
FoodNetSupplemental1_FN Highlights_FDD MMG cross walk_ALL_20190815.xlsx |
Supplementary Document |
Uploaded 2019-10-25 |
Available |
FoodNetSupplemental2_FoodNet Variable List_mapping to MMG DRAFT.XLSX |
Supplementary Document |
Uploaded 2019-10-25 |
Repair queued |
Non-Sub ChgReq_0920-0978(121019)_OMBupdates (002).doc |
Justification for No Material/Nonsubstantive Change |
Uploaded 2019-12-12 |
Repair queued |
Privacy Act Checklist.docx |
Supplementary Document |
Uploaded 2019-02-22 |
Available |
Attachment 33 - Non-research determination.pdf |
Supplementary Document |
Uploaded 2019-02-22 |
Available |
Att 32- Flu PIA.pdf |
Supplementary Document |
Uploaded 2019-02-22 |
Available |
Att 31- ABCs PIA.pdf |
Supplementary Document |
Uploaded 2019-02-22 |
Available |
Att 30 - FoodNet PIA.pdf |
Supplementary Document |
Uploaded 2019-02-22 |
Available |
Att 29- HAIC PIA.pdf |
Supplementary Document |
Uploaded 2019-02-22 |
Repair queued |
60 Day FRN.pdf |
Supplementary Document |
Uploaded 2019-02-22 |
Repair queued |
Att 1- Authorizing_Regulations_T42_section_241.pdf |
Supplementary Document |
Uploaded 2019-02-22 |
Available |
Non-sub change request_2018.doc |
Justification for No Material/Nonsubstantive Change |
Uploaded 2018-09-13 |
Repair queued |
CDI_Non-sub change request_FINAL_20180524.doc |
Justification for No Material/Nonsubstantive Change |
Uploaded 2018-05-31 |
Repair queued |
Part B_EIP OMB 2018 Revision_20180926.docx |
Supporting Statement B |
Uploaded 2019-02-22 |
Repair queued |
Part A_EIP OMB 2018 Revision_20180926 ICRO revised.docx |
Supporting Statement A |
Uploaded 2019-02-22 |
Repair queued |