Information Collection

HL7 Reporting Guide

IC 245684 under ICR 202102-0920-006 · OMB 0920-1349.

Documents and Forms

Document Name Document Type
Form 0920- HL7 Reporting Guide Form
0920- CSV File or HL7 messages (retrospective data entry) 5. CDC provided CSV file or HL7 messages retrospective data entry.docx Form
0920- CSV File or HL7 messages (retrospective data entry) 5. CDC provided CSV file or HL7 messages retrospective data entry.docx Form
4. HL7 Reporting Guide.pdf HL& Reporting Guide IC Document
4. HL7 Reporting Guide.pdf HL& Reporting Guide IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	HL7 Reporting Guide	Agency IC Tracking Number:	0920-

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-	CSV File or HL7 messages (retrospective data entry)	5. CDC provided CSV file or HL7 messages retrospective data entry.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	54	54
Annual IC Time Burden (Hours)	216	216
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
HL& Reporting Guide	4. HL7 Reporting Guide.pdf	02/08/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.