Information Collection

Assessment of Asian-American and Pacific Islanders Community Health Organizations' (AAPCHO) Providers Knowledge, Attitudes, and Practices Regarding Latent TB Infection

IC 229238 under ICR 201705-0920-017 · OMB 0920-1027.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1027 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1027 Assessment of Asian-American and Pacific Islanders Community Health Organizations' (AAPCHO) Providers Knowledge, Attitudes, and Practices Regarding Latent TB Infection	Form and Instruction
0920-1027 AAPCHO/MAYO Clinic Tuberculosis Assessment Att1 -AAPCHO TB Online Survey Screen.docx	Form and Instruction
Att2 -Email Templates for AAPCHO Site Recruitment_CDC.docx Email Template for Site Recruitment for TB Online Survey	IC Document
Att3 - Flyer for AAPCHO Site Recruitment_CDC.docx Flyer - AAPCHO/MAYO Tuberculosis Project Information Sheet	IC Document
PD 7045 Assessment of the Association of Asian Pacific Community Health Latent TB.pdf Project Determination and Approval	IC Document
Generic Clearance Template_AAPCHO Survey.docx GenIC Request	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Assessment of Asian-American and Pacific Islanders Community Health Organizations' (AAPCHO) Providers Knowledge, Attitudes, and Practices Regarding Latent TB Infection

Agency IC Tracking Number:

0920-1027-18HA

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	0920-1027	AAPCHO/MAYO Clinic Tuberculosis Assessment	Att1 -AAPCHO TB Online Survey Screen.docx	NA	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	100	100
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Email Template for Site Recruitment for TB Online Survey	Att2 -Email Templates for AAPCHO Site Recruitment_CDC.docx	12/01/2017
Flyer - AAPCHO/MAYO Tuberculosis Project Information Sheet	Att3 - Flyer for AAPCHO Site Recruitment_CDC.docx	12/01/2017
Project Determination and Approval	PD 7045 Assessment of the Association of Asian Pacific Community Health Latent TB.pdf	12/01/2017
GenIC Request	Generic Clearance Template_AAPCHO Survey.docx	12/01/2017

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