Attachment B1 – Pre-notice Form approved
OMB No. 0920-1154
Expiration Date: 01/31/2020
Dear [Name of PI/PM],
The CDC Environmental Public Health Tracking Program Tracking program in collaboration with the National Association of Health Data Organizations (NAHDO) is conducting a Needs Assessment to assess the current status of the Tracking Program’s hospitalization data partnership, including data acquisition and utility.
All Tracking recipient programs will be asked to complete an online survey to gather information about the hospitalization data (inpatient and emergency department visit) your program receives and uses for Tracking applications.
The online survey should be completed by the individual(s) that is/are most knowledgeable about accessing and using hospitalization data for your Tracking program. Please email Emily Sullivan ([email protected]) the name, business email address, and phone number of the person most knowledgeable about hospitalization data in your program by (DATE). All PI/PMs will be copied in the survey email invite. We anticipate the survey will be sent by (DATE).
Kind regards,
Emily Sullivan
Deputy Director
National Association of Health Data Organizations
P: 801-532-2292
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Please list the name, business email address, and phone number of the person most knowledgeable about hospitalization data in your program below. Email the information below to Emily Sullivan ([email protected]).
Name: ________________________________________________________________________
Business Email Address: __________________________________________________________
Phone number: _________________________________________________________________
CDC estimates the average public reporting burden for this collection of information as 5 minutes per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1154)
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | esullivan |
| File Modified | 0000-00-00 |
| File Created | 2021-01-15 |