OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

National Network of Sexually Transmitted Disease Clinical Prevention Traning Centers (NNPTC)

ICR 202003-0920-018 · OMB 0920-0995 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-0995 Basic Post Course Evaluation Form and Instruction New Available
Form 0920-0995 Basic Long-Term Evaluation Form and Instruction Modified Available
Form 0920-0995 Short Guidelines Long-Term Evaluation Form and Instruction Modified Available
Form 0920-0995 Short Guidelines Post-Course Evaluation Form and Instruction Modified Available
Form 0920-0995 STD Treatment Guidelines Complete Long-Term Evaluation Form and Instruction Modified Available
Form 0920-0995 STD Treatment Guidelines Complete Post -Course Evaluation Form and Instruction Modified Repair queued
Form 0920-0995 Wet Mount Long-Term Evaluation Form and Instruction Modified Available
Form 0920-0995 Wet Mount Post-Course Evaluation Form and Instruction Modified Available
Form 0920-0995 Practicum Long-Term Evaluation Form Modified Repair queued
Form 0920-0995 Practicum Post-Course Evaluation Form and Instruction Modified Available
Form 0920-0995 Intensive-Didactic Long-Term Evaluation Form and Instruction Modified Available
Form 0920-0995 Intensive-Didactic Post Course Evaluation Form and Instruction Modified Available
Form 0920-0995 Intensive Complete Long-Term Evaluation Form and Instruction Modified Repair queued
Form 0920-0995 Intensive Complete Post-Couse Evaluation Form and Instruction Modified Available
Form 0920-0995 NNPTC Abbreviated Health Professional Applicaton for Traiing (HPAT) Form and Instruction Modified Available
SupSta A final.docx Supporting Statement A Uploaded 2020-04-03 Repair queued
Performance Measures STD Prevention OMB PRA Privacy Act Checklist Template 0920-0995.docx Supplementary Document Uploaded 2020-03-30 Available
CDC_PRA_Determination_Form 0920 0995.pdf Supplementary Document Uploaded 2020-03-30 Available
Att 39 Evaluation questions by instrument.xlsx Supplementary Document Uploaded 2020-03-30 Available
Att 38 Table with Description of Attachments.docx Supplementary Document Uploaded 2020-03-30 Available
Att 37 Project Determination.pdf Supplementary Document Uploaded 2020-03-30 Available
Att 3c Table of revisions to HPAT wordversion + cover sheet.docx Supplementary Document Uploaded 2020-03-30 Repair queued
Att 2 60 Day FRN Published 110419.pdf Supplementary Document Uploaded 2020-03-30 Available
Att 1 Authorizing Legislation Section 301 PHSA.docx Supplementary Document Uploaded 2020-03-30 Available
SupSta B 0920-0995.docx Supporting Statement B Uploaded 2020-03-30 Available
IC Document Collections
IC IDCollectionTypeStatusForm
241012 Basic Post Course Evaluation Form and Instruction New
225770 3 Month Long-Term Email Invitation Instruction Modified
225769 Immediate Post-Course Email Invitation Instruction Modified
225768 Basic Long-Term Evaluation Form and Instruction Modified
225767 Short Guidelines Long-Term Evaluation Form and Instruction Modified
225766 Short Guidelines Post-Course Evaluation Form and Instruction Modified
225765 STD Treatment Guidelines Complete Long-Term Evaluation Form and Instruction Modified
225764 STD Treatment Guidelines Complete Post -Course Evaluation Form and Instruction Modified
225763 Wet Mount Long-Term Evaluation Form and Instruction Modified
225762 Wet Mount Post-Course Evaluation Form and Instruction Modified
225748 Practicum Long-Term Evaluation Form Modified
225747 Practicum Post-Course Evaluation Form and Instruction Modified
225745 Intensive-Didactic Long-Term Evaluation Form and Instruction Modified
225742 Intensive-Didactic Post Course Evaluation Form and Instruction Modified
225741 Intensive Complete Long-Term Evaluation Form and Instruction Modified
225738 Intensive Complete Post-Couse Evaluation Form and Instruction Modified
208451 NNPTC Abbreviated Health Professional Applicaton for Traiing (HPAT) Form and Instruction Modified
ICR Details
0920-0995 202003-0920-018
Active 201702-0920-011
HHS/CDC 0920-0995
National Network of Sexually Transmitted Disease Clinical Prevention Traning Centers (NNPTC)
Extension without change of a currently approved collection   No
Regular
Approved without change 06/23/2020
Retrieve Notice of Action (NOA) 04/06/2020
  Inventory as of this Action Requested Previously Approved
06/30/2023 36 Months From Approved 06/30/2020
11,769 0 7,152
502 0 423
0 0 0
The purpose of this data collection is to support program management of the National Network of Sexually Transmitted Disease Clinical Prevention Training Center (NNPTC) and to evaluate the reach and impact of the NNPTC's training activities. This extension does not include any major changes.
PL: Pub.L. 42 - 792 776 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  84 FR 59381 11/04/2019
85 FR 18982 04/03/2020
No
17
IC Title Form No. Form Name
Intensive Complete Long-Term Evaluation 0920-0995, 0920-0995 Intensive Complete Long-Term Evaluation wordversion ,   Intensive Complete Long-Term Evaluation -Screenshot
Wet Mount Long-Term Evaluation 0920-0995, 0920-0995 Wet Mount Long-Term wordversion ,   Wet Mount Long Term Evaluation -Screenshot
Intensive-Didactic Long-Term Evaluation 0920-0995, 0920-0995 Intensive Didactic Long-Term Evaluation wordversion ,   Intensive Didactic Long-Term Evaluation -Screenshot
STD Treatment Guidelines Complete Post -Course Evaluation 0920-0995, 0920-0995 STD Tx Guidelines Complete Post-course Evaluation ,   STD Tx Guidelines Complete Post-Course Evaluation screenshot
Basic Post Course Evaluation 0920-0995, 0920-0995 Basic Post Course Evaluation ,   Basic Post Course Evaluation screenshot
Practicum Post-Course Evaluation 0920-0995, 0920-0995 Practicum Post-Course Evaluation wordversion ,   Practicum Post-Course Evaluation -Screenshot
Practicum Long-Term Evaluation 0920-0995, 0920-0995 Practicum 3-month Long-Term Evaluation -Screenshot ,   Practicum Long-Term Evaluation wordversion
Intensive Complete Post-Couse Evaluation 0920-0995, 0920-0995 Intensive Complete Post-Course Evaluation wordversion ,   Intensive Complete Post-Course Evaluation -Screenshot
Intensive-Didactic Post Course Evaluation 0920-0995, 0920-0995 Intensive Didactic Post-Course Evaluation wordversion ,   Intensive Didactic Post-Course Evaluation – Screenshot
3 Month Long-Term Email Invitation
NNPTC Abbreviated Health Professional Applicaton for Traiing (HPAT) 0920-0995, 0920-0995 NNPTC Abbreviated HPAT wordversion ,   Abbreiviated HPAT Screenshot
Wet Mount Post-Course Evaluation 0920-0995, 0920-0995 Wet Mount Post-Course Evaluation wordversion ,   Wet Mount Post-Course Evaluation -Screenshot
STD Treatment Guidelines Complete Long-Term Evaluation 0920-0995, 0920-0995 STD Tx Guidelines Complete Long-Term Evaluation ,   STD Tx Guidelines Complete Long-Term Evaluation screenshot
Short Guidelines Post-Course Evaluation 0920-0995, 0920-0995 STD Tx Guidelines Short Post-Course Evaluation wordversion ,   STD Tx Guidelines Short Post-Course Evaluation -Screenshot
Short Guidelines Long-Term Evaluation 0920-0995, 0920-0995 STD Tx Guidelines Short Long-Term Evaluation wordversion ,   STD Tx Guidelines Short Long-Term Evaluation -Screenshot
Basic Long-Term Evaluation 0920-0995, 0920-0995 Basic Long Term Evaluation ,   Basic Long Term Evaluation screenshot
Immediate Post-Course Email Invitation
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 11,769 7,152 0 4,617 0 0
Annual Time Burden (Hours) 502 423 0 79 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Burden didn't actually increase. The last package ICs were not entered correctly but the burden remains 502 hrs.
$102,783
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
No
Kevin Joyce 404 639-1944 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/06/2020