57.312 Hemovigilance Adverse Reaction - Hypotensive Transfusion Reaction

[NCEZID] The National Healthcare Safety Network (NHSN)

OMB: 0920-0666

IC ID: 222899

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57.312 Hemovigilance Adverse Reaction - Hypotensive Transfusion Reaction 0920-0666
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 57.312 Hemovigilance Adverse Reaction - Hypotensive Transfusion Reaction 57.312_HV AR-HTR_BLANK.docx Yes Yes Fillable Printable
Form CDC 57.312 Hemovigilance Adverse Reaction - Hypotensive Transfusion Reaction (with modified GISAB questions) 57.312_HV-AR-HTR_OMB.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

500 0
   
Private Sector Businesses or other for-profits
 
   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 500 0 0 0 0 500
Annual IC Time Burden (Hours) 175 0 0 0 0 175
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Hemovigilance Adverse Reaction - Hypotensive Transfusion Reaction (with modified GISAB questions in tracked changes) 57.312_HV-AR-HTR_OMB.docx 04/25/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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