Information Collection

Implementing Public Health Genomics in Your State: Resources from CDC Office of Public Health

IC 224566 under ICR 201606-0920-007 · OMB 0920-0974.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-17FC Implementing Public Health Genomics in Your State: Resources from CDC Office of Public Health	Form and Instruction
Webinar Survey Invitation.docx	Instruction
0920-17FC Genomics Survey for Webinar 2016_11_18 Genomics Survey for Webinar 2016_11_18.xlsx	Form and Instruction
11_7 Fast_Track_GenIC_RequestTemplate OPHG_resources_webinar rev LEC 2016_.docx 11_7 Fast_Track_GenIC_RequestTemplate OPHG_resources_webinar rev LEC 2016_	IC Document
New Requirements for Supporting Statement A.docx New Requirements for Supporting Statement A	IC Document

IC Title:

Agency IC Tracking Number:

17FC

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	0920-17FC	Genomics Survey for Webinar 2016_11_18	Genomics Survey for Webinar 2016_11_18.xlsx		Yes	Yes	Fillable Fileable
Instruction			Webinar Survey Invitation.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	150	150
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
11_7 Fast_Track_GenIC_RequestTemplate OPHG_resources_webinar rev LEC 2016_	11_7 Fast_Track_GenIC_RequestTemplate OPHG_resources_webinar rev LEC 2016_.docx	11/23/2016
New Requirements for Supporting Statement A	New Requirements for Supporting Statement A.docx	11/23/2016

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