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Form 57.208 Healthcare Worker Vaccination History
The National Healthcare Safety Network (NHSN)
57.208_HCWVaccHistory_BLANK.ppt
57.208 Healthcare Worker Vaccination History
OMB: 0920-0666
OMB.report
HHS/CDC
OMB 0920-0666
ICR 201105-0920-001
IC 183580
Form 57.208 Healthcare Worker Vaccination History
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0666 can be found here:
2025-03-28 - No material or nonsubstantive change to a currently approved collection
2024-12-23 - Revision of a currently approved collection
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File Type
application/vnd.ms-powerpoint
File Title
Slide 1
Author
Jasie L. Jackson
Last Modified By
fom7
File Modified
2010-09-15
File Created
2007-04-19
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