Information Collection

National Syndromic Surveillance Program Community of Practice Assessment

IC 231188 under ICR 201711-0920-012 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
National Syndromic Surveillance Program Community of Practice Assessment	Form
Community of Practice Assessment - word Attachment B-NSSP CoP Instrument Word.docx	Form
Community of Practice - web Attachment C-NSSP CoP Instrument Web Version.pdf	Form
NSSP-COP-SSA.docx Supporting Statement A	IC Document
NSSP-COP-SSB.docx Supporting Statement B	IC Document
Attachment A-List of Respondents.docx List of Respondents	IC Document
Attachment D NSSP CoP notification email.docx Notification Email	IC Document
Attachment E-NSSP CoP Reminder email.docx Reminder Email	IC Document

IC Title:

National Syndromic Surveillance Program Community of Practice Assessment

Agency IC Tracking Number:

0920-0879-18ACF

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	none	Community of Practice Assessment - word	Attachment B-NSSP CoP Instrument Word.docx		Yes	Yes	Fillable Fileable
Form	none	Community of Practice - web	Attachment C-NSSP CoP Instrument Web Version.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 153

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	153	153
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
Supporting Statement A	NSSP-COP-SSA.docx	04/24/2018
Supporting Statement B	NSSP-COP-SSB.docx	04/24/2018
List of Respondents	Attachment A-List of Respondents.docx	04/24/2018
Notification Email	Attachment D NSSP CoP notification email.docx	04/24/2018
Reminder Email	Attachment E-NSSP CoP Reminder email.docx	04/24/2018

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