OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

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

ICR 202202-0920-013 · OMB 0920-0995 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Intensive Long-Term Evaluation Form and Instruction New Repair queued
Intensive Post-Course Evaluation Form and Instruction New Repair queued
Standard Long-Term Evaluation Form and Instruction New Repair queued
Standard Post-Course Evaluation Form and Instruction New Available
Form 0920-0995 Basic Post Course Evaluation Form and Instruction Removed Repair queued
Form 0920-0995 Basic Long-Term Evaluation Form and Instruction Removed Repair queued
Form 0920-0995 Short Guidelines Long-Term Evaluation Form and Instruction Removed Repair queued
Form 0920-0995 Short Guidelines Post-Course Evaluation Form and Instruction Removed Repair queued
Form 0920-0995 STD Treatment Guidelines Complete Long-Term Evaluation Form and Instruction Removed Available
Form 0920-0995 STD Treatment Guidelines Complete Post -Course Evaluation Form and Instruction Removed Repair queued
Form 0920-0995 Wet Mount Long-Term Evaluation Form and Instruction Removed Repair queued
Form 0920-0995 Wet Mount Post-Course Evaluation Form and Instruction Removed Repair queued
Form 0920-0995 Practicum Long-Term Evaluation Form and Instruction Removed Repair queued
Form 0920-0995 Practicum Post-Course Evaluation Form and Instruction Removed Repair queued
Form 0920-0995 Intensive-Didactic Long-Term Evaluation Form and Instruction Removed Repair queued
Form 0920-0995 Intensive-Didactic Post Course Evaluation Form and Instruction Removed Repair queued
Form 0920-0995 Intensive Complete Long-Term Evaluation Form and Instruction Removed Repair queued
Form 0920-0995 Intensive Complete Post-Couse Evaluation Form and Instruction Removed Repair queued
NNPTC Abbreviated Health Professional Applicaton for Traiing (HPAT) Form and Instruction Modified Repair queued
0920-0995 Change Request_02222022.docx Justification for No Material/Nonsubstantive Change Uploaded 2022-02-22 Missing upstream
SupSta A final.docx Supporting Statement A Uploaded 2020-04-03 Missing upstream
Performance Measures STD Prevention OMB PRA Privacy Act Checklist Template 0920-0995.docx Supplementary Document Uploaded 2020-03-30 Repair queued
CDC_PRA_Determination_Form 0920 0995.pdf Supplementary Document Uploaded 2020-03-30 Repair queued
Att 39 Evaluation questions by instrument.xlsx Supplementary Document Uploaded 2020-03-30 Repair queued
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 Repair queued
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 Repair queued
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 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
251729 Intensive Long-Term Evaluation Form and Instruction New
251728 Intensive Post-Course Evaluation Form and Instruction New
251727 Standard Long-Term Evaluation Form and Instruction New
251726 Standard Post-Course Evaluation Form and Instruction New
241012 Basic Post Course Evaluation Form and Instruction Removed
225770 3 Month Long-Term Email Invitation Instruction Unchanged
225769 Immediate Post-Course Email Invitation Instruction Unchanged
225768 Basic Long-Term Evaluation Form and Instruction Removed
225767 Short Guidelines Long-Term Evaluation Form and Instruction Removed
225766 Short Guidelines Post-Course Evaluation Form and Instruction Removed
225765 STD Treatment Guidelines Complete Long-Term Evaluation Form and Instruction Removed
225764 STD Treatment Guidelines Complete Post -Course Evaluation Form and Instruction Removed
225763 Wet Mount Long-Term Evaluation Form and Instruction Removed
225762 Wet Mount Post-Course Evaluation Form and Instruction Removed
225748 Practicum Long-Term Evaluation Form and Instruction Removed
225747 Practicum Post-Course Evaluation Form and Instruction Removed
225745 Intensive-Didactic Long-Term Evaluation Form and Instruction Removed
225742 Intensive-Didactic Post Course Evaluation Form and Instruction Removed
225741 Intensive Complete Long-Term Evaluation Form and Instruction Removed
225738 Intensive Complete Post-Couse Evaluation Form and Instruction Removed
208451 NNPTC Abbreviated Health Professional Applicaton for Traiing (HPAT) Form and Instruction Modified
ICR Details
0920-0995 202202-0920-013
Received in OIRA 202003-0920-018
HHS/CDC 0920-0995
National Network of Sexually Transmitted Disease Clinical Prevention Traning Centers (NNPTC)
No material or nonsubstantive change to a currently approved collection   No
Regular 02/23/2022
  Requested Previously Approved
06/30/2023 06/30/2023
11,680 11,769
453 502
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. The purpose of this Change Request (submitted February 2022) is to consolidate forms across activities. This consolidation will support a unified evaluation plan.
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
7
IC Title Form No. Form Name
3 Month Long-Term Email Invitation
Basic Long-Term Evaluation 0920-0995, 0920-0995 Basic Long Term Evaluation ,   Basic Long Term Evaluation screenshot
Basic Post Course Evaluation 0920-0995, 0920-0995 Basic Post Course Evaluation ,   Basic Post Course Evaluation screenshot
Immediate Post-Course Email Invitation
Intensive Complete Long-Term Evaluation 0920-0995, 0920-0995 Intensive Complete Long-Term Evaluation wordversion ,   Intensive Complete Long-Term Evaluation -Screenshot
Intensive Complete Post-Couse Evaluation 0920-0995, 0920-0995 Intensive Complete Post-Course Evaluation wordversion ,   Intensive Complete Post-Course Evaluation -Screenshot
Intensive Long-Term Evaluation None Intensive Long-Term Evaluation
Intensive Post-Course Evaluation None Intensive Post-Course Evaluation
Intensive-Didactic Long-Term Evaluation 0920-0995, 0920-0995 Intensive Didactic Long-Term Evaluation wordversion ,   Intensive Didactic Long-Term Evaluation -Screenshot
Intensive-Didactic Post Course Evaluation 0920-0995, 0920-0995 Intensive Didactic Post-Course Evaluation wordversion ,   Intensive Didactic Post-Course Evaluation – Screenshot
NNPTC Abbreviated Health Professional Applicaton for Traiing (HPAT) None NNPTC Abbreviated Health Professional Application for Training
Practicum Long-Term Evaluation 0920-0995, 0920-0995 Practicum Long-Term Evaluation wordversion ,   Practicum 3-month Long-Term Evaluation -Screenshot
Practicum Post-Course Evaluation 0920-0995, 0920-0995 Practicum Post-Course Evaluation wordversion ,   Practicum 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
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
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
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
Standard Long-Term Evaluation None Standard Long-Term Evaluation
Standard Post-Course Evaluation None Standard Post-Course Evaluation
Wet Mount Long-Term Evaluation 0920-0995, 0920-0995 Wet Mount Long-Term wordversion ,   Wet Mount Long Term Evaluation -Screenshot
Wet Mount Post-Course Evaluation 0920-0995, 0920-0995 Wet Mount Post-Course Evaluation wordversion ,   Wet Mount Post-Course Evaluation -Screenshot
  Total Request 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 11,680 11,769 0 -89 0 0
Annual Time Burden (Hours) 453 502 0 -49 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Changing Forms
The purpose of this Change Request (submitted February 2022) is to consolidate forms across activities. This consolidation will support a unified evaluation plan, by type of evaluation. In the majority of instances, burden per response will be reduced.
$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.
02/23/2022