Information Collection

Health Professional Applicaton for Traiing (HPAT)

IC 208451 under ICR 201309-0920-002 · OMB 0920-0995.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0995 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 3 HPAT- Paper.docx	Other-WORD
Att 4 HPAT screenshots.docx	Other-WORD

IC Title:

Health Professional Applicaton for Traiing (HPAT)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD			Att 3 HPAT- Paper.docx		Yes	Yes	Fillable Printable
Other-WORD			Att 4 HPAT screenshots.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title: 09-20-0161 "Records of Health Professionals in Disease Prevention and Control Training Programs"

FR Citation: 51 FR 42485

Number of Respondents: 7,400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 70 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,400	7,400
Annual IC Time Burden (Hours)	617	617
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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