Information Collection

Public Health Associate Program (PHAP) Alumni Assessment

IC 216295 under ICR 201503-0920-010 · OMB 0920-1078.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1078 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Public Health Associate Program (PHAP) Alumni Assessment	Form and Instruction
Public Health Associate Program (PHAP) Alumni Assessment Att C PHAP Alumni Assessment_Web Version.docx	Form and Instruction

IC Title:

Public Health Associate Program (PHAP) Alumni Assessment

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
Form and Instruction	None	Public Health Associate Program (PHAP) Alumni Assessment	Att C PHAP Alumni Assessment_Web Version.docx	None	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

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: 160

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	160	160
Annual IC Time Burden (Hours)	21	21
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.