View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	[PHIC/NCEH] EPH Practice Repository: Piloting the Collection and Dissemination of Environmental Public Health Practices (2025-2026)	Agency IC Tracking Number:	0920-25-0157

IC Status: New

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	n/a	EPH Survey	Att_A_EPHSurvey_RC_08212025.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 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	15	0	15	0	0	0
Annual IC Time Burden (Hours)	120	0	120	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Invitation to Participate	Att_C_Invitation_08062025.docx	08/27/2025
Survey Email	Att_D_Survey_Email_08062025.docx	08/27/2025
Glossary	Att_E_Glossary_08062025.docx	08/27/2025
Reminder Email	Att_F_Reminder_08062025.docx	08/27/2025
Research Determination	STARS project determination.pdf	08/27/2025
SSA	SSA_EPHPractice_08062026.docx	08/27/2025
SSB	SSB_EPHPractice_08062026.docx	08/27/2025
EPH Survey (Word)	Att_B_EPHSurvey_08212025.docx	08/27/2025

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