2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form

[NCEZID] Emerging Infections Program

Documents and Forms

Document Name Document Type
Form ABC.100.3 2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Form and Instruction
Form ABC.100.3 2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Form and Instruction
ABC.100.3 2019 ABC H. Influenzae Neonatal Sepsis Expanded Surveill ABC.100.3 ABCs H. influenzae Neonatal Sepsis Expanded Surveillance Form.pdf Form and Instruction
ABC.100.3 2019 ABC H. Influenzae Neonatal Sepsis Expanded Surveill ABC.100.3 ABCs H. influenzae Neonatal Sepsis Expanded Surveillance Form.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	2019 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form	Agency IC Tracking Number:	0920-0978

Is this a Common Form? No		IC Status: Unchanged

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 and Instruction	ABC.100.3	2019 ABC H. Influenzae Neonatal Sepsis Expanded Surveillance Form	ABC.100.3 ABCs H. influenzae Neonatal Sepsis Expanded Surveillance Form.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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