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

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCHHSTP)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

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:

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

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 %

	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

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.