Information Collection Request

[NCEZID] Emerging Infections Program

ICR 202504-0920-028 · OMB 0920-0978 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form HAIC.400.13 Data Elements Transferred to CDC for the HAIC Death Ascertainment Project Form and Instruction Unchanged Available
Form HAIC.400.13 Data Elements Transferred to CDC for the HAIC Death Ascertainment Project Form and Instruction Unchanged Repair queued
Form HAIC.400.3 2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey Form and Instruction Unchanged Available
Form HAIC.400.3 2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey Form and Instruction Unchanged Missing upstream
Form HAIC.400.2 Community-Associated CP-CRE Interview Form and Instruction Unchanged Available
Form HAIC.400.2 Community-Associated CP-CRE Interview Form and Instruction Unchanged Missing upstream
Form HAIC.400.12 HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE Form and Instruction Unchanged Repair queued
Form HAIC.400.12 HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE Form and Instruction Unchanged Repair queued
Form HAIC.400.6 2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey Form and Instruction Unchanged Repair queued
Form HAIC.400.6 2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey Form and Instruction Unchanged Repair queued
Form HAIC.400.5 CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey Form and Instruction Unchanged Repair queued
Form HAIC.400.5 CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey Form and Instruction Unchanged Repair queued
Form HAIC.400.10 Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey Form and Instruction Unchanged Repair queued
Form HAIC.400.10 Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey Form and Instruction Unchanged Repair queued
Form HAIC.400.9 HAIC-Surveillance Officer's Survey Form and Instruction Unchanged Repair queued
Form HAIC.400.9 HAIC-Surveillance Officer's Survey Form and Instruction Unchanged Repair queued
Form HAIC.400.8 Annual Survey of Laboratory Testing Practices for C. difficile Infection Form and Instruction Unchanged Available
Form HAIC.400.8 Annual Survey of Laboratory Testing Practices for C. difficile Infection Form and Instruction Unchanged Available
Form FSN.300.4 FluSurv-NET Laboratory Survey 2023–2024 Season Form Unchanged Available
Form FSN.300.4 FluSurv-NET Laboratory Survey 2023–2024 Season Form Unchanged Missing upstream
Form FN.200.10 FoodNET Lab Survey Variable List 2024 Form Unchanged Repair queued
Form FN.200.10 FoodNET Lab Survey Variable List 2024 Form Unchanged Repair queued
Form HAIC 400.11 CANDIDEMIA 2024 CASE REPORT FORM Form and Instruction Modified Available
Form HAIC 400.11 CANDIDEMIA 2024 CASE REPORT FORM Form and Instruction Modified Repair queued
Form HAIC 400.4 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report Form and Instruction Modified Repair queued
Form HAIC 400.4 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report Form and Instruction Modified Repair queued
Form FSN.300.3 FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM Form and Instruction Unchanged Repair queued
Form FSN.300.3 FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM Form and Instruction Unchanged Repair queued
Form ABC.100.4 ABCs Severe GAS Infection: Supplemental Form Form and Instruction Unchanged Repair queued
Form ABC.100.4 ABCs Severe GAS Infection: Supplemental Form Form and Instruction Unchanged Repair queued
Form ABC.100.3 2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Form and Instruction Unchanged Available
Form ABC.100.3 2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Form and Instruction Unchanged Missing upstream
Form HAIC 400.1 2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report Form and Instruction Modified Repair queued
Form HAIC 400.1 2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report Form and Instruction Modified Repair queued
Form HAIC 400.7 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT Form and Instruction Modified Repair queued
Form HAIC 400.7 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT Form and Instruction Modified Available
Form FN.200.8 FoodNet Variable List, 2024_ (YERSINIA) Form and Instruction Unchanged Available
Form FN.200.8 FoodNet Variable List, 2024_ (YERSINIA) Form and Instruction Unchanged Repair queued
Form FN.200.7 FoodNet Variable List, 2024_ (VIBRIO) Form and Instruction Unchanged Available
Form FN.200.7 FoodNet Variable List, 2024_ (VIBRIO) Form and Instruction Unchanged Repair queued
Form FN.200.6 FoodNet Variable List, 2024_ (SHIGELLA) Form and Instruction Unchanged Repair queued
Form FN.200.6 FoodNet Variable List, 2024_ (SHIGELLA) Form and Instruction Unchanged Repair queued
Form FN.200.5 FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI) Form and Instruction Unchanged Repair queued
Form FN.200.5 FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI) Form and Instruction Unchanged Repair queued
Form FN.200.4 FoodNet Variable List, 2024_ (SALMONELLA) Form and Instruction Unchanged Repair queued
Form FN.200.4 FoodNet Variable List, 2024_ (SALMONELLA) Form and Instruction Unchanged Repair queued
Form FN.200.3 FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES) Form and Instruction Unchanged Repair queued
Form FN.200.3 FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES) Form and Instruction Unchanged Repair queued
Form FN.200.2 FoodNet Variable List, 2024_ (CYCLOSPORA) Form and Instruction Unchanged Repair queued
Form FN.200.2 FoodNet Variable List, 2024_ (CYCLOSPORA) Form and Instruction Unchanged Repair queued
Form FN.200.1 FoodNet Variable List, 2024_(CAMPYLOBACTER) Form and Instruction Unchanged Repair queued
Form FN.200.1 FoodNet Variable List, 2024_(CAMPYLOBACTER) Form and Instruction Unchanged Repair queued
Form FSN.300.2 FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish) Form and Instruction Unchanged Available
Form FSN.300.2 FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish) Form and Instruction Unchanged Repair queued
Form ABC 200.9 FoodNet Hemolytic Uremic Syndrome (HUS) Form and Instruction Modified Repair queued
Form ABC 200.9 FoodNet Hemolytic Uremic Syndrome (HUS) Form and Instruction Modified Repair queued
Form FSN.300.1 FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form Form and Instruction Unchanged Available
Form FSN.300.1 FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form Form and Instruction Unchanged Repair queued
Form ABC.100.5 Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form Form and Instruction Unchanged Available
Form ABC.100.5 Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form Form and Instruction Unchanged Repair queued
Form ABC.100.2 ABCs Invasive Pneumococcal Disease in Children and Adults Form and Instruction Unchanged Repair queued
Form ABC.100.2 ABCs Invasive Pneumococcal Disease in Children and Adults Form and Instruction Unchanged Repair queued
Form ABC.100.1 2024 Active Bacterial Core Surveillance (ABCs) Case Report Form and Instruction Unchanged Repair queued
Form ABC.100.1 2024 Active Bacterial Core Surveillance (ABCs) Case Report Form and Instruction Unchanged Repair queued
EIP Change Request Memo - EO14168.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-28 Repair queued
EIP Change Request Memo - EO14168.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-28 Missing upstream
Supporting Statement B_EIP OMB_updated_Clean.docx Supporting Statement B Uploaded 2025-04-28 Repair queued
Supporting Statement B_EIP OMB_updated_Clean.docx Supporting Statement B Uploaded 2025-04-28 Repair queued
Supporting Statement A_EIP OMB_updated_clean.docx Supporting Statement A Uploaded 2025-04-28 Available
Supporting Statement A_EIP OMB_updated_clean.docx Supporting Statement A Uploaded 2025-04-28 Repair queued
EIP 0920-0978_Non-sub change request_2025 08OCT2024.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-10-08 Available
EIP 0920-0978_Non-sub change request_2025 08OCT2024.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-10-08 Missing upstream
Att 2_Collection Instrument Cross walk.docx Supplementary Document Uploaded 2024-10-08 Available
Att 2_Collection Instrument Cross walk.docx Supplementary Document Uploaded 2024-10-08 Repair queued
Att 1 Program ChangesAdjustments_rev 08OCT2024.docx Supplementary Document Uploaded 2024-10-08 Repair queued
Att 1 Program ChangesAdjustments_rev 08OCT2024.docx Supplementary Document Uploaded 2024-10-08 Repair queued
Att. 6-Explanation for Program Changes.docx Supplementary Document Uploaded 2024-07-11 Repair queued
Att. 6-Explanation for Program Changes.docx Supplementary Document Uploaded 2024-07-11 Repair queued
Att. 5-Human Subjects Determination Memo.pdf Supplementary Document Uploaded 2024-07-11 Repair queued
Att. 5-Human Subjects Determination Memo.pdf Supplementary Document Uploaded 2024-07-11 Repair queued
Att. 4a-Privacy Impact Assessment.pdf Supplementary Document Uploaded 2024-07-11 Available
Att. 4a-Privacy Impact Assessment.pdf Supplementary Document Uploaded 2024-07-11 Repair queued
Att. 2-Federal Register 60day FRN.pdf Supplementary Document Uploaded 2024-07-11 Repair queued
Att. 2-Federal Register 60day FRN.pdf Supplementary Document Uploaded 2024-07-11 Missing upstream
Att. 1-Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document Uploaded 2024-07-11 Repair queued
Att. 1-Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document Uploaded 2024-07-11 Available
IC Document Collections
IC IDCollectionTypeStatusForm
253051 Data Elements Transferred to CDC for the HAIC Death Ascertainment Project Form and Instruction Unchanged
253051 Data Elements Transferred to CDC for the HAIC Death Ascertainment Project Form and Instruction Unchanged
253049 2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey Form and Instruction Unchanged
253049 2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey Form and Instruction Unchanged
253048 Community-Associated CP-CRE Interview Form and Instruction Unchanged
253048 Community-Associated CP-CRE Interview Form and Instruction Unchanged
235058 HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE Form and Instruction Unchanged
235058 HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE Form and Instruction Unchanged
235057 2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey Form and Instruction Unchanged
235057 2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey Form and Instruction Unchanged
235056 CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey Form and Instruction Unchanged
235056 CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey Form and Instruction Unchanged
235055 Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey Form and Instruction Unchanged
235055 Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey Form and Instruction Unchanged
235054 HAIC-Surveillance Officer's Survey Form and Instruction Unchanged
235054 HAIC-Surveillance Officer's Survey Form and Instruction Unchanged
235053 Annual Survey of Laboratory Testing Practices for C. difficile Infection Form and Instruction Unchanged
235053 Annual Survey of Laboratory Testing Practices for C. difficile Infection Form and Instruction Unchanged
235052 FluSurv-NET Laboratory Survey 2023–2024 Season Form Unchanged
235052 FluSurv-NET Laboratory Survey 2023–2024 Season Form Unchanged
235051 FoodNET Lab Survey Variable List 2024 Form Unchanged
235051 FoodNET Lab Survey Variable List 2024 Form Unchanged
231114 CANDIDEMIA 2024 CASE REPORT FORM Form and Instruction Modified
231114 CANDIDEMIA 2024 CASE REPORT FORM Form and Instruction Modified
231113 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report Form and Instruction Modified
231113 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report Form and Instruction Modified
231111 FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM Form and Instruction Unchanged
231111 FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM Form and Instruction Unchanged
230869 ABCs Severe GAS Infection: Supplemental Form Form and Instruction Unchanged
230869 ABCs Severe GAS Infection: Supplemental Form Form and Instruction Unchanged
220380 2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Form and Instruction Unchanged
220380 2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Form and Instruction Unchanged
217336 2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report Form and Instruction Modified
217336 2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report Form and Instruction Modified
217334 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT Form and Instruction Modified
217334 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT Form and Instruction Modified
207663 FoodNet Variable List, 2024_ (YERSINIA) Form and Instruction Unchanged
207663 FoodNet Variable List, 2024_ (YERSINIA) Form and Instruction Unchanged
207662 FoodNet Variable List, 2024_ (VIBRIO) Form and Instruction Unchanged
207662 FoodNet Variable List, 2024_ (VIBRIO) Form and Instruction Unchanged
207661 FoodNet Variable List, 2024_ (SHIGELLA) Form and Instruction Unchanged
207661 FoodNet Variable List, 2024_ (SHIGELLA) Form and Instruction Unchanged
207660 FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI) Form and Instruction Unchanged
207660 FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI) Form and Instruction Unchanged
207659 FoodNet Variable List, 2024_ (SALMONELLA) Form and Instruction Unchanged
207659 FoodNet Variable List, 2024_ (SALMONELLA) Form and Instruction Unchanged
207658 FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES) Form and Instruction Unchanged
207658 FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES) Form and Instruction Unchanged
207657 FoodNet Variable List, 2024_ (CYCLOSPORA) Form and Instruction Unchanged
207657 FoodNet Variable List, 2024_ (CYCLOSPORA) Form and Instruction Unchanged
207655 FoodNet Variable List, 2024_(CAMPYLOBACTER) Form and Instruction Unchanged
207655 FoodNet Variable List, 2024_(CAMPYLOBACTER) Form and Instruction Unchanged
207653 FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish) Form and Instruction Unchanged
207653 FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish) Form and Instruction Unchanged
207652 FoodNet Hemolytic Uremic Syndrome (HUS) Form and Instruction Modified
207652 FoodNet Hemolytic Uremic Syndrome (HUS) Form and Instruction Modified
207651 FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form Form and Instruction Unchanged
207651 FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form Form and Instruction Unchanged
207649 Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form Form and Instruction Unchanged
207649 Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form Form and Instruction Unchanged
207648 ABCs Invasive Pneumococcal Disease in Children and Adults Form and Instruction Unchanged
207648 ABCs Invasive Pneumococcal Disease in Children and Adults Form and Instruction Unchanged
207646 2024 Active Bacterial Core Surveillance (ABCs) Case Report Form and Instruction Unchanged
207646 2024 Active Bacterial Core Surveillance (ABCs) Case Report Form and Instruction Unchanged
ICR Details
0920-0978 202504-0920-028
Active 202410-0920-009
HHS/CDC 0920-0978-25-0107
[NCEZID] Emerging Infections Program
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 05/09/2025
Retrieve Notice of Action (NOA) 05/01/2025
  Inventory as of this Action Requested Previously Approved
09/30/2027 09/30/2027 09/30/2027
88,158 0 88,158
40,013 0 40,013
0 0 0

The Emerging Infections Programs (EIP) is to 1) detect and monitor emerging pathogens, the diseases they cause, and the factors influencing their emergence, and respond to problems as they are identified, 2) integrate laboratory science and epidemiology to optimize public health practice, 3) strengthen infrastructure to support surveillance and research and to implement prevention and control programs, and to 4) ensure implementation of prevention strategies and communication of public health information about emerging diseases. Surveillance efforts of the core EIP activities generate reliable estimates of the incidence of certain infections and provide the foundation for a variety of epidemiologic studies. This Non-Substantive Change Request is submitted to make modifications to 13 data collection forms in the 0920-0978 package for compliance with EO 14168. There is no anticipated change to the approved burden hours.

US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  89 FR 14501 02/27/2024
89 FR 58736 07/19/2024
No

32
IC Title Form No. Form Name
2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form ABC.100.3 2019 ABC H. Influenzae Neonatal Sepsis Expanded Surveillance Form
2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey HAIC.400.6, HAIC 400.6 2023 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey ,   2024 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey
2024 (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report HAIC 400.1, HAIC 400.1 2024 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report_rev 2025 ,   2025 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare-Associated Infections Community Interface (HAIC) Case Report _rev 2025
2024 Active Bacterial Core Surveillance (ABCs) Case Report ABC.100.1, ABC 100.1 2024 Active Bacterial Core Surveillance (ABCs) Case Report ,   2025 Active Bacterial Core Surveillance (ABCs) Case Report
2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey HAIC.400.3 2024 HAIC Multi-site Gram-negative Surveillance Initiative (MuGSI) Supplemental Surveillance Officer Survey
ABCs Invasive Pneumococcal Disease in Children and Adults ABC.100.2, ABC 100.2 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN (aged ≥2 months to <5 years) AND ADULTS (aged ≥65 years) ,   2025 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN (aged ≥2 months to <5 years) AND ADULTS (aged ≥65 years)
ABCs Severe GAS Infection: Supplemental Form ABC.100.4 ABCs Severe GAS Infection: Supplemental Form
Active Bacterial Core Surveillance (ABCs) Neonatal Infection Expanded Tracking Form ABC 100.5, ABC.100.5 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) NEONATAL INFECTION EXPANDED TRACKING FORM ,   2025 ACTIVE BACTERIAL CORE SURVEILLANCE (ABCs) NEONATAL INFECTION EXPANDED TRACKING FORM
Annual Survey of Laboratory Testing Practices for C. difficile Infection HAIC 400.8, HAIC.400.8 Annual Survey of Laboratory Testing Practices for C. difficile Infection ,   Annual Survey of Laboratory Testing Practices for C. difficile Infection
CANDIDEMIA 2024 CASE REPORT FORM HAIC 400.11, HAIC 400.11 CANDIDEMIA 2024 CASE REPORT FORM_rev 2025 ,   CANDIDEMIA 2025 CASE REPORT FORM_rev 2025
CDC's Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey HAIC.400.5 CDC’s Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus aureus 2024 Laboratory Survey
CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT HAIC 400.7, HAIC 400.7 2024 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT_rev 2025 ,   2025 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT_ rev 2025
Community-Associated CP-CRE Interview HAIC.400.2 Community-Associated CP-CRE Interview
Data Elements Transferred to CDC for the HAIC Death Ascertainment Project HAIC.400.13 Data Elements Transferred to CDC for the HAIC Death Ascertainment Project
Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey HAIC.400.10 Emerging Infections Program C. difficile Surveillance Nursing Home Telephone Survey
FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW (English/Spanish) FSN.300.2 FLUSURV-NET: CONSENT FORM FOR PATIENT/PROXY INTERVIEW
FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM FSN.300.3 FLUSURV-NET: PROVIDER PEDIATRIC VACCINATION HISTORY REQUEST LETTER/FORM
FluSurv-NET Laboratory Survey 2023–2024 Season FSN.300.4 FluSurv-NET Laboratory Survey 2023–2024 Season
FluSurv-Net Influenza Hospitalization Surveillance Network Case Report Form FSN 300.1, FSN.300.1 Influenza Hospitalizatin Surveillance Network (FluSurv-NET) Case Report Form ,   2024-25 Influenza Hospitalization Surveillance Network (FluSurv-NET) Case Report Form
FoodNET Lab Survey Variable List 2024 FN.200.10 FoodNET Lab Survey Variable List, 2024
FoodNet Hemolytic Uremic Syndrome (HUS) ABC 200.9 FoodNet CDC's FoodNet Hemolytic Uremic Syndrome (HUS) Surveillance Case Report Form_rev 2025
FoodNet Variable List, 2024_ (CYCLOSPORA) FN 200.2, FN.200.2 FoodNet Variable List, 2024_ (CYCLOSPORA) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (LISTERIA MONOCTOGENES) FN 200.3, FN.200.3 FoodNet Variable List, 2024_ (LISTERIA MONOCYTOGENES) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (SALMONELLA) FN 200.4, FN.200.4 FoodNet Variable List, 2024_ (SALMONELLA) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI) FN 200.5, FN.200.5 FoodNet Variable List, 2024_ (SHIGA TOXIN PRODUCING E.COLI) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (SHIGELLA) FN 200.6, FN.200.6 FoodNet Variable List, 2024_ (SHIGELLA) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (VIBRIO) FN 200.7, FN.200.7 FoodNet Variable List, 2024_ (VIBRIO) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_ (YERSINIA) FN 200.8, FN.200.8 FoodNet Variable List, 2024_ (YERSINIA) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
FoodNet Variable List, 2024_(CAMPYLOBACTER) FN 200.1, FN.200.1 FoodNet Variable List, 2024_ (CAMPYLOBACTER) ,   FoodNet Variable List, (Site-transmitted variables) - 2025
HAIC-Surveillance Officer's Survey HAIC.400.9, HAIC 400.9 HAIC Surveillance Officer’s Survey ,   HAIC Surveillance Officer’s Survey
HAIC_LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE HAIC 400.12, HAIC.400.12 2024 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE ,   2025 LABORATORY TESTING PRACTICES FOR CANDIDEMIA QUESTIONNAIRE
Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report HAIC 400.4, HAIC 400.4, HAIC 400.4, HAIC 400.4, HAIC 400.4, HAIC 400.4 2024 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report_rev 2025 ,   2025 Invasive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report_rev 2025 ,   2022 Invasive Methicillin-Resistant Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report _rev 2025 ,   2023 Invasive Methicillin-Resistant Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report _rev 2025 ,   2022 Invasive Methicillin-Sensitive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report _rev 2025 ,   2023 Invasive Methicillin-Sensitive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report _rev 2025

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 88,158 88,158 0 0 0 0
Annual Time Burden (Hours) 40,013 40,013 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$41,699,051
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
No
Jeffrey Zirger 404 639-7118 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/01/2025