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[CSTLTS] Disease Intervention Specialist (DIS) Workforce Assessment 0920-0879-23CX
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0879 Disease Intervention Professional Enumeration Study (Local) Attachment E- Instrument Local Web Version.pdf Yes Yes Fillable Fileable
Form and Instruction 0920-0879 Disease Intervention Professional Enumeration Study (State & Territorial) Attachment C- Instrument State and Territorial Web Version.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

491 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved 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 491 0 491 0 0 0
Annual IC Time Burden (Hours) 985 0 985 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A DIS Enumeration SSA.docx 03/01/2023
Supporting Statement B DIS Enumeration SSB.docx 03/01/2023
Att A_State, Territorial, and Local Health Departments Attachment A- State, Territorial, and Local Health Departments.docx 03/03/2023
Att B_Instrument State and Territorial Word Version Attachment B- Instrument State and Territorial Word Version.docx 03/03/2023
Att D_Instrument Local Word Version Attachment D- Instrument Local Word Version.docx 03/03/2023
Att F_State and Territorial Notification Email Attachment F- State and Territorial Notification Email.docx 03/03/2023
Att G_State and Territorial Reminder Email Attachment G- State and Territorial Reminder Email.docx 03/03/2023
Att G_State and Territorial Extension Email Attachment H- State and Territorial Extension Email.docx 03/03/2023
Att I_ Local Notification Email Attachment I- Local Notification Email.docx 03/03/2023
Att J_Local Reminder Email Attachment J- Local Reminder Email.docx 03/03/2023
Att K_ Local Extension Email Attachment K- Local Extension Email.docx 03/03/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.