Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
'SSPRACTICE' New 31 8 0 Other-WORD
ASPR Temporary Reassignment Request New 60 30 0 Form none
Assessment of Health Dept. Antibiotic Stewardship Roles and Activities New 60 40 0 Other-Interview Guide
Assessment of Tobacco Control Program (TCP) Infrastructure New 51 77 0 Form and Instruction None
Assessment of Waste Left in Place (WLIP) Ordinances New 100 7 0 Form and Instruction NA
Assessment of the 2011 CDC Protocol Change for Flight-Related Tuberculosis Contact Investigations New 125 42 0 Form and Instruction NA
Assessment of the 2014 Best Practices Guide for Comprehensive Tobacco Control Programs New 51 60 0 Form and Instruction NA
Assessment of the STD AAPPS Funding Program New 118 197 0 Form none
Other-Interview Guide
Assessment of the Tuberculosis Laboratory Aggregate Report New 58 15 0 Form none
Awareness and Practice of Disaster Risk Reduction for Health: A National Assessment New 56 9 0 Form and Instruction NA
BE Review (Built Environment) Healthy Community Design: Assessment of Local Health and Planning Departments New 1130 283 0 Form and Instruction None
Form and Instruction None
Community Health Status Indicators (CHSI) 2015: Awareness, Use, and Benefits Assessment New 78 37 0 Form and Instruction 16ADY
Form and Instruction 16ADY
Form and Instruction 16ADY
Community Health Worker Certification: Effective Strategies and Potential Challenges New 49 74 0 Form and Instruction N/A
County Health Policy Implementation Assessment New 120 47 0 Form none
Form none
Form none
Form none
Early Care and Education (ECE) State Indicator Assessment New 102 30 0 Form and Instruction NA
Emerging Issues for Private Wells - CSTE Assessment New 55 55 0 Form none
Form none
Epi-Aid Satisfaction and Impact Assessment New 60 15 0 Form none
Form none
Federally Unregulated Drinking Water Programs: Assessing Strategies Leading to Policy Change New 18 23 0 Form and Instruction NA
GenIC XDRCI-COST New 45 104 0 Instruction
Instruction
Other-Excel
Instruction
Instruction
Other-WORD
HHS Region VI Virtual Tabletop Exercise Assessment New 140 42 0 Form none
Form none
HIV Health Improvement Affinity Group Assessment New 146 82 0 Form none
Form none
Other-Interview Guide
Mass Gathering Outbreaks: Assessment of Frequency, Policy and Communication Strategies New 81 41 0 Form none
Instruction
Maternal and Child Health Zika Capacity Assessment New 690 104 0 Form and Instruction NA
NGWA_Intervention to Prevent Exposure to Contaminants in Drinking Water New 30 30 0 Other-WORD
Needs Assessment for Developing a Network of LEHPs New 500 125 0 Other-WORD
Other-Screenshots
Non-Infectious Drinking Water Issues CSTE New 55 36 0 Form and Instruction 0920-16NK
Form and Instruction 0920-16NK
Preexposure Prophylaxis: Local Health Dept. Assessment New 500 250 0 Form none
Form none
Prescription Drug Overdose Prevention for States Program Assessment New 87 174 0 Other-Interview Guide
Preventive Health and Health Services Block Grant Assessment New 61 61 0 Form and Instruction n/a
Other-For Reference: WORD version of the questionnaire
Public Health Law Program Needs Assessment New 500 67 0 Form none
Public Health Preparedness Capabilities Assessment (PHEPCAPSUR) New 62 62 0 Other-WORD
Other-Screenshots
RSB Product and STLT Preparedness Assessment New 336 112 0 Other-WORD
Other-Screenshots
STD/HIV Disease Intervention Specialist (DIS) Workforce Assessment New 499 167 0 Form and Instruction NA
School Health Resources Assessment: Awareness, Satisfaction, and Utility New 85 16 0 Other-WORD
Other-Web Version
School Health Resources: Assessing Awareness, Satisfaction, and Utility New 127 77 0 Form and Instruction N/A
Form and Instruction N/A
Form and Instruction N/A
Special Bacteriology Reference Laboratory Assessment New 51 9 0 Form and Instruction 0920-0879
Form and Instruction 0920-0879
State & Local HH & LPP Programs: Baseline Profile Assessment New 35 5 0 Form and Instruction 0920-0879
Form and Instruction 0920-0879
State Chronic Disease Prevention and Control Programs: Training Needs New 357 156 0 Form and Instruction NA
Form and Instruction NA
State and Local Public Health Planners: Pandemic Preparedness Readiness New 496 341 0 Form and Instruction None
Form and Instruction None
Form and Instruction None
Form and Instruction None
Form and Instruction None
Form and Instruction None
Form and Instruction None
Form and Instruction None
Syndromic Surveillance: Success Stories from the Field Guide from Not CDC Funded State & Local Health Departments New 34 57 0 Form Attachment C
Syndromic Surveillance: Success Stories from the Field from NSSP Awardees New 31 52 0 Form Attachment C
Systematic Identification and Assessment of Sexual Violence Prevention Strategies New 525 424 0 Other-word
Form none
Treatment of Pediatric ADHD: An Assessment of State Medicaid Policies New 51 17 0 Form N/A
Usability and Needs Assessment of CDC's State, Tribal, Local, and Territorial Gateway Website New 2913 576 0 Form and Instruction n/a
Other-Reference document: WORD version of Web Quesionnaire Content
Form and Instruction n/a
Other-Reference document: WORD version of Card Sorting Instrument Content
VCASSESS New 2181 273 0 Other-WORD
Other-WEB VERSION
Waterborne Disease Prevention: State Program Assessment New 28 28 0 Instruction
genIC Cancer Survivorship Needs Assessment for NCCCProgram Grantees New 65 87 0 Other-WORD
Other-Web Version
Other-WORD
Other-WORD
Other-WORD
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 13033 4624 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title