Case Study of the Career Epidemiology Field Officer Assignments in Three State Health Department

Surveys of State, Tribal, Local and Territorial (STLT) Governmental Health Agencies

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
Case Study of the Career Epidemiology Field Officer Assignments in Three State Health Department Form and Instruction
Supervisor Interview CEFO ATTACHMENT B- Supervisor Instrument_11 21 13.docx Form and Instruction
Partner Interview CEFO ATTACHMENT C- Partner Instrument_11 21 13.docx Form and Instruction
CEFO ATTACHMENT D-Email Notification_11 21 13.docx D - Email Notification IC Document
CEFO ATTACHMENT A- Field Assignments Map 11 18 13.pdf A - Map of Field Assignments IC Document
CEFO ATTACHMENT E- Email Reminder 11 21 13.docx E - Email Reminder IC Document
CEFO Supporting Statement A_ 11 21 13.docx Supporting Statement A IC Document
CEFO Supporting Statement B_11 21 13.docx Supporting Statement B IC Document

Information Collection (IC) Details

IC Title:	Case Study of the Career Epidemiology Field Officer Assignments in Three State Health Department	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	none	Supervisor Interview	CEFO ATTACHMENT B- Supervisor Instrument_11 21 13.docx		No	No	Printable Only
Form and Instruction	none	Partner Interview	CEFO ATTACHMENT C- Partner Instrument_11 21 13.docx		No	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 18	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	18	0	0	0	0	0
Annual IC Time Burden (Hours)	15	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
D - Email Notification	CEFO ATTACHMENT D-Email Notification_11 21 13.docx	11/21/2013
A - Map of Field Assignments	CEFO ATTACHMENT A- Field Assignments Map 11 18 13.pdf	11/20/2013
E - Email Reminder	CEFO ATTACHMENT E- Email Reminder 11 21 13.docx	11/21/2013
Supporting Statement A	CEFO Supporting Statement A_ 11 21 13.docx	11/21/2013
Supporting Statement B	CEFO Supporting Statement B_11 21 13.docx	11/21/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.