OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

[NCEH] Poison Center Collaborations for Public Health Emergencies

ICR 202603-0920-016 · OMB 0920-1166 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Att7_Example Parent-Child Questionnaire.docx Supplementary Document Uploaded 2026-04-15 Available
Att6_Example Adolescent Questionnaire.docx Supplementary Document Uploaded 2026-04-15 Available
Att5_Example Adult Questionnaire.docx Supplementary Document Uploaded 2026-04-15 Available
Att2c1_Public Comment Response 3.docx Public Comments Uploaded 2026-04-15 Available
Att2c_CDC-2025-1014-0003.pdf Public Comments Uploaded 2026-04-15 Available
Att2b1_Public Comment Response 2.docx Public Comments Uploaded 2026-04-15 Available
Att2b_CDC-2025-1014-0002.pdf Public Comments Uploaded 2026-04-15 Available
Att2a1_ Public Comment Response 1.pdf Public Comments Uploaded 2026-04-15 Available
Att2a_CDC-2025-1014-0004.pdf Public Comments Uploaded 2026-04-15 Available
Att8_Example Web Questionnaire.pdf Supplementary Document Uploaded 2026-04-15 Available
Att16_NCEH Research and PRA Determination.pdf Supplementary Document Uploaded 2026-04-15 Available
Att15_Agreemnt Prohibit Identifiers.pdf Supplementary Document Uploaded 2026-04-15 Available
Att13_Burden Memo PCCPHE.docx Supplementary Document Uploaded 2026-04-15 Available
Att12_Sample Consent and Assent Forms.docx Supplementary Document Uploaded 2026-04-15 Available
Att11_GenIC Rqst Apprvl Form PCCPHE.docx Supplementary Document Uploaded 2026-04-15 Available
Att10_Advanced Notification Email for OMB.docx Supplementary Document Uploaded 2026-04-15 Available
Att9_Step-by-Step How to Use the Generic Clearance.docx Supplementary Document Uploaded 2026-04-15 Available
Att4_Data Licensing Agreement.pdf Supplementary Document Uploaded 2026-04-15 Available
Att2_0920-1166_60D FRN.pdf Supplementary Document Uploaded 2026-04-15 Available
Att1 Authorizing Legislation.pdf Supplementary Document Uploaded 2026-04-15 Available
1 - List of Attachments PCCPHE_2026.docx Supplementary Document Uploaded 2026-04-15 Available
SSB PCCPHE Revision_March 2026_CDC.docx Supporting Statement B Uploaded 2026-04-15 Available
SSA_0920-1166 [NCEH] March 2026_CDC.docx Supporting Statement A Uploaded 2026-04-15 Available
IC Document Collections
IC IDCollectionTypeStatusForm
ICR Details
0920-1166 202603-0920-016
Received in OIRA 202211-0920-012
HHS/CDC 0920-26-0162
[NCEH] Poison Center Collaborations for Public Health Emergencies
Revision of a currently approved collection   No
Regular 04/16/2026
  Requested Previously Approved
36 Months From Approved 04/30/2026
1,500 1,500
250 250
0 0
The goal of this information collection is to create a timely mechanism which will allow a network of regional, state, and local poison centers, supported by CDC, to obtain critical exposure and health information during a public health emergency. This additional information will improve public health response for the site-specific public health emergency or incident. As questions will be tailored to the nature of the public health emergency/incident—a generic mechanism is being employed for collections within this scope to permit rapid response to urgent public health problems. Data collection instruments and methods must be rapidly created and implemented to direct appropriate public health action. Data collection for investigations conducted under this generic will not exceed 60 days. This is a revision Generic ICR. The following minor changes were made by updating web-based questionnaire development from EpiInfo TM to REDCap, and updating the number of poison centers from 55 to 53.
US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  91 FR 1796 01/15/2026
91 FR 19140 04/14/2026
Yes
0
  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 1,500 1,500 0 0 0 0
Annual Time Burden (Hours) 250 250 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$122,784
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Odion Clunis 770 488-0045 [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.
04/16/2026