Preventive Medicine Fellowship Residency Program Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Backup of SS_ PART B.wbk	Supporting Statement B	Uploaded 2008-01-25	Available
Attachment 6. Public comment on federal register receved 3-14-07 vol 72 pg 11887 (0920-07AP).doc	Supplementary Document	Uploaded 2008-01-25	Available
Attatchment 5. PMRF Practicum Year Logic Model 0907 2007 .doc	Supplementary Document	Uploaded 2008-01-25	Available
Attachment 4. PMRF Eligibility Requirements.doc	Supplementary Document	Uploaded 2008-01-25	Available
Attachment 2 0920-007AP 60-Day - published 03-14-07 in the FR.pdf	Supplementary Document	Uploaded 2008-01-25	Available
Attachment 1 PH service act.doc	Supplementary Document	Uploaded 2008-01-25	Available
SS_PART A.doc	Supporting Statement A	Uploaded 2008-01-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
183885	Survey for Veterinarians in Reference Group	Other-Survey	New
183884	Survey for Veterinarians in Study Group	Other-Survey	New
183883	Survey for Physicians in Reference Group	Other-Survey	New
183882	Survey for Physicians in Study Group	Other-Survey	New

ICR Details

OMB Control No: 0920-0785	ICR Reference No: 200802-0920-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Preventive Medicine Fellowship Residency Program Evaluation
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/01/2008
	Date Received in OIRA: 02/25/2008
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2011	36 Months From Approved
Responses	30	0	0
Time Burden (Hours)	16	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The mission of CDC's Preventive Medicine Residency and Fellowship is to train public health and preventive medicine leaders, and maintain leadership in the field of preventive medicine training. The results of the proposed evaluation will be used to provide recommendations for continuing the program as is, or for improvements to curriculum or other program elements.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 11887	03/14/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 7289	02/07/2008
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Survey for Physicians in Study Group
Survey for Physicians in Reference Group
Survey for Veterinarians in Study Group
Survey for Veterinarians in Reference Group

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ICR Summary of Burden

table that charts list of burden

	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	30	0	0	30	0	0
Annual Time Burden (Hours)	16	0	0	16	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new data collection.

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Annual Cost to Federal Government: $1,053

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 02/25/2008

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