Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Assess Breast and Cervical Cancer Screening Program Activities to Expand Access to Screening New 67 31 0 Form none Assess Breast and Cervical Cancer Screening Program Activities
Assessing Satisfaction and Utility of OSTLTS Communication Products for Health Department Staff New 750 188 0 Form and Instruction None Attachment F: Assessing Satisfaction and Utility of OSTLTS Communication Products for Health Department Staff-Word Version
Form and Instruction None Attachment G--Assessing Satisfaction and Utility of OSTLTS Communication Products for Health Department Staff--Web-version
Assessing Analytic Tools and Practices of STLT Health Dept. Data Analysts New 2121 955 0 Form none Assessment of STLT Grantee SAS Users
Form none Assessment of Principal Grant Contacts
Assessing Effectiveness Brochure: LHD/NHHE Progam Working Together AND STD Prevention Services New 877 209 0 Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Assessing the Needs and Capacity of State Newborn Screening Programs and Laboratories New 88 45 0 Form none Newborn Screening Lab Survey
Form none Newborn Screening Program Survey
Assessing the Utility of the Community Guide Website and Products Among STLT Email Subscribers New 2326 310 0 Form none CG Web Survey - Word
Form none CG Web Survey - screenshots
Assessment of Awareness and Use of Epidemiology and Analysis Program Office Products New 342 143 0 Form none Awareness and Use of EAPO Products
Assessment of Characteristics of State Crash Outcome Data Evaluation Systems New 35 18 0 Form and Instruction 0920-0879 Attachment K Screen shot of questionnaire
Form and Instruction 0920-0879 AttachmentJ - Questionnaire WORD version
Instruction
Form and Instruction 0920-0879 Attachment M Email notification 10312012
Form and Instruction 0920-0879 Attachment N Email with survey link
Assessment of Characteristics of State Crash Outcome Data Evaluation Systems: Focus Groups New 116 189 0 Form and Instruction none Att E - Focus Group Scheduling Email
Form none Att G - Screenshots of Doodle Poll
Form and Instruction none Att H - Focus Group Script
Assessment of Evaluation Capacity among State and Territorial Early Hearing Detection and Intervention (EHDI) Program Coodinators New 52 13 0 Form and Instruction 0920-0879 EHDI- Attachment C- Data Collection Instrument web version
Instruction
Form and Instruction 0920-0879 EHDI- Attachment D- Data Collection Instrument Word version
Instruction
Form and Instruction 0920-0879 EHDI- Attachment G- Self Assessment Follow up
Assessment of Local Health Departments' Interventions to Address TB among Persons Experiencing Homelessness New 220 73 0 Form None Health Department Homeless TB Data Collection Instrument
Form None Health Department Homeless TB Data Collection Instrument--Screenshots
Assessment of Performance Management and Improvement Practices New 74 31 0 Form none NPHII Annual Assessment
Assessment of Public Health Veterinarians Regarding the Sale, Display, and Exhibition of "Exotic" Animals New 66 19 0 Form and Instruction none Assessment of Public Health Veterinarians Regarding the Sale, Display, and Exhibition of "Exotic" Animals
Other-Screenshots of Attachment B
Assessment of State Public Health Department Immunization Billing Reimbursement Projects New 35 20 0 Form none Billables Project Assessment
Assessment of State/Local STD Clinic Directors Perceptions and Attitudes Regarding CDC Field Staff New 59 30 0 Form and Instruction 0920-0879 STD Field Staff ATTACHMENT B Instrument
Form and Instruction 0920-0879 STD Field Staff ATTACHMENT C Instrument-Online
Assessments of the Quality and Utility of National Public Health Improvement Initiative to Support STLT New 176 142 0 Form and Instruction none Focus Group Guide
Form none Att H - TA Satisfaction Screen Shots
Biosense Submission Processes Assessment New 56 85 0 Instruction
Other-Interview
Birth Certificate and Hospital Discharge Linkage - State Survey New 104 43 0 Form none Birth Certificate and Hospital Discharge Survey - AMCHP
Form none Birth Certificate and Hospital Discharge - NAPHSIS
CDC Guidelines for the Field Triage of Injured Patients: National Evaluation New 50 17 0 Form none Assessment of CDC Guidelines for the Field Triage of Injured Patients
CDC Infectious Diseases Reference Laboratories Customer Satisfaction Survey New 55 9 0 Form none CDC ID Reference Labs Customer Satisfaction Survey
CPPW Resource Center Feedback Assessment and IMATS Assessment New 414 138 0 Form none CPPW Web Survey
Form none IMATS Web Survey
Case Study of the Career Epidemiology Field Officer Assignments in Three State Health Department New 18 15 0 Form and Instruction none Supervisor Interview
Form and Instruction none Partner Interview
Evaluating the Health Hazard Evaluation Program's Communication with Local Health Departments New 52 9 0 Form none Survey (Word)
Form none Survey (Web)
Evaluation of CDC Service Provided to Public Health Labs to Rapidly Identify Multidrug-Resistant Isolates of TB New 344 61 0 Form none Evaluation of Detection of Drug Resistance Testing Service
Form none Drug Susceptability Test Results
Health Department Use and Application of CDC Drug Resistant TB Laboratory Services New 60 15 0 Other-WORD
Other-WORD
Internet Partner Service Activities and Guidelines for HIV Testing at Refugee Screening New 925 372 0 Form none ISP PM Data Collection
Form none ISP Assessment
Form none Assessment of Guidelines for HIV Testing in Refugees
National Outbreak Reporting System: An Evaluation of Foodborne Disease Outbreak Surveillance and Technical Requirements for Reporting New 130 43 0 Form and Instruction none Att G - Survey Instrument
Form and Instruction none Att H - Survey Screenshots
Public Health Law Training and Technical Assistance Needs Assessment and Pandemic Influenza Nonpharmaceutical Interventions New 853 246 0 Form and Instruction 1 PH Law Survey
Form and Instruction 2 PH Law web survey
Form and Instruction 3 PanFlu Survey
Form and Instruction 4 PanFlu Web Survey
Public Health Practice Stories from the Field New 276 1932 0 Other-Word
SHD Reporting (14EU) and Testing Practices and TB Elimination FOA (14GS) New 230 58 0 Form none Survey for Epidemiologist
Form none Survey for Microbiolgist
Form none TB Instrument - Web
State and Local Environmental Public Health Employees Usage of Public Health Assessments and Consultations Documents New 150 125 0 Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Technical Assistance and Service Improvement Initiative (TASII) New 2541 1482 0 Form none Survey Web Screenshots
Form none Survey Notification Email
Form none Survey Reminder Emails
Utility and Value of Flexible Epidemiologists New 20 13 0 Form none Interview Guide - PI
Form none Interview Guide - Epidemiologist
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 13682 7079 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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