Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
[PHIC/NCEH] EPH Practice Repository: Piloting the Collection and Dissemination of Environmental Public Health Practices (2025-2026) New 15 120 0 Form and Instruction n/a EPH Survey
[PHIC/NCEZID] Use and Acceptability of the Model Aquatic Health Code (2024) Unchanged 1373 706 0 Form 0920-0879 MAHC Use and Acceptability Survey (EpiInfo Web Survey)
Form and Instruction 0920-0879 Focus Group Discussion Guide—Moderate MAHC Use and Implementation
Form and Instruction 0920-0879 Focus Group Discussion Guide—Moderate MAHC Use and Implementation
Form and Instruction 0920-0879 Focus Group Discussion Guide—Advanced MAHC Use and Implementation
Form and Instruction 0920-0879 Case Study In-Depth Interview Guide
[PHIC/NCHHSTP] 2024 TB Training and Education Needs Assessment – The U.S.-affiliated Pacific Islands – Online Survey Unchanged 78 32 0 Form and Instruction n/a 2024 Tuberculosis (TB) Training and Education Needs Assessment of the U.S.-affiliated Pacific Islands
[PHIC/NCIRD] Pediatric Hepatitis-Adenovirus Case Control Evaluation, United States 2022-2026 (24CN) Unchanged 5000 375 0 Form and Instruction 0920-0879 PEDIATRIC HEPATITIS OF UNKNOWN ETIOLOGY MEDICAL RECORD ABSTRACTION FORM
Form and Instruction 0920-0879 Pediatric Hepatitis of Unknown Etiology - Exposures Questionnaire (Parental Interview)
Form and Instruction 0920-0879 Pediatric Hepatitis of Unknown Etiology - Exposures Questionnaire CONTROL (Parental Interview)
Form and Instruction 0920-0879 Hepatitis pediátrica de etiología desconocida - Cuestionario sobre exposiciones (entrevista a los padres)
Form and Instruction 0920-0879 Hepatitis pediátrica de etiología desconocida. CONTROL del cuestionario sobre exposiciones (Entrevista a los padres)
[PHIC] 2025 Assessment of a Novel Funding Approach for Improving Health in Rural Communities New 144 144 0 Form and Instruction n/a Rural Carveout Survey
Form and Instruction n/a Rural Carveout Interview - SHD
Form and Instruction n/a Rural Carveout Interview - SORH
[PHIC] 2025 Training Needs Assessment - U.S. Public Health Mycobacteriology Laboratories Online Questionnaire New 58 15 0 Form and Instruction n/a 2025 Training Needs Assessment – U.S. Public Health Mycobacteriology Laboratories Online Questionnaire
[PHIC] 2025 U.S. Pathogen and Genomics Centers for Excellence (PGCoE) Interim Assessment New 276 177 0 Form and Instruction n/a PGCoE Interim Assessment Survey Data Collection Tool
Form and Instruction n/a PGCoE Interim Assessment Focus Group Script/ Discussion Guide
[PHIC] Assessing Funded Overdose Data to Action (OD2A) Grantee Implementation and Impacts of Stop Overdose Campaigns Unchanged 90 38 0 Form and Instruction 0920-0879 O2DA Partner Evaluation Survey: Screener and Annotated Questionnaire
Form and Instruction 0920-0879 O2DA Partner Evaluation Survey: Screener and Annotated Questionnaire
[PHIC] CDC Funded Recipient Experience Survey Unchanged 2000 533 0 Form and Instruction n/a CDC Funded Recipient Experience Survey
[PHIC] Developing Capacity to Decontaminate/Evacuate Vulnerable Persons During an Emergency (2025) New 105 88 0 Form and Instruction n/a Call for Data
Form and Instruction n/a Semi-Structured Interview
[PHIC] Information Collections to Advance State, Tribal, Local and Territorial (STLT) Governmental Agency System Performance, Capacity, and Program Delivery New 1 1 0 Other-Discontinue data collection
[PHIC] OT21-2103 Success Stories (2024-2026) Unchanged 2160 13320 0 Form and Instruction n/a OT20-2103 Success Stories Form
[PHIC] State Dental Director and Key Oral Health Program Staff Survey (2025) New 19 14 0 Form and Instruction n/a State Dental Director and Key Oral Health Program Staff Survey
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 11319 15563 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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