NNPTC Abbreviated Health Professional Applicaton for Traiing (HPAT)

National Network of Sexually Transmitted Disease Clinical Prevention Traning Centers (NNPTC)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 0920-0995 NNPTC Abbreviated Health Professional Applicaton for Traiing (HPAT) Form and Instruction
0920-0995 Att 3 NNPTC Abbreviated HPAT wordversion Att 3 NNPTC Abbreviated HPAT wordversion.docx Form and Instruction
0920-0995 Att 4 Abbreiviated HPAT Screenshot Att 4 Abbreiviated HPAT Screenshot.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	NNPTC Abbreviated Health Professional Applicaton for Traiing (HPAT)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	0920-0995	Att 3 NNPTC Abbreviated HPAT wordversion	Att 3 NNPTC Abbreviated HPAT wordversion.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-0995	Att 4 Abbreiviated HPAT Screenshot	Att 4 Abbreiviated HPAT Screenshot.pdf		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: 4,500	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,500	4,500
Annual IC Time Burden (Hours)	225	225
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.