Information Collection Request
[NCEH] Poison Center Collaborations for Public Health Emergencies
ICR 202211-0920-012 · OMB 0920-1166 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-1166 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 0 - PCCPHE ICR Privacy Act Checklist 20221109.docx |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| 1 - List of Attachments PCCPHE_20221109.docx |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
 Att15_Agreemnt Prohibit Identifiers.pdf |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| 1 - SSB PCCPHE Revision_20221109.docx |
Supporting Statement B | Uploaded 2022-11-18 | Missing upstream |
| 1 - SSA PCCPHE Revision_20221109.docx |
Supporting Statement A | Uploaded 2022-11-18 | Repair queued |
| Att14_Privacy Impact Assessment PCCPHE.pdf |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| Att8_Example Web Questionnaire.pdf |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| Att16_NCEH STARS Determination PCCPHE.pdf |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| Att13_Burden Memo PCCPHE.docx |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| Att7_Example Parent-Child Questionnaire.docx |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| Att6_Example Adolescent Questionnaire.docx |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| Att5_Example Adult Questionnaire.docx |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| Att12_Sample Consent and Assent Forms.docx |
Supplementary Document | Uploaded 2022-11-18 | Missing upstream |
| Att11_GenIC Rqst Apprvl Form PCCPHE.docx |
Supplementary Document | Uploaded 2022-11-18 | Missing upstream |
| Att10_Advanced Notification Email for OMB.docx |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| Att9_Step-by-Step How to Use the Generic Clearance.docx |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| Att4_Data Licensing Agreement.pdf |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| Att3_Poison Center Map.pdf |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| Att2_60D FRN PCCPHE.pdf |
Supplementary Document | Uploaded 2022-11-18 | Repair queued |
| Att1 Authorizing Legislation.pdf |
Supplementary Document | Uploaded 2020-02-18 | Repair queued |
| 0920-1166 Change Request Justification FY2020 Q1.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2020-01-23 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-1166 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202002-0920-001 |
| Agency Tracking No | 0920-1166 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |