National Syndromic Surveillance Program Community of Practice Assessment

Information Collections to Advance State, Tribal, Local and Territorial (STLT) Governmental Agency System Performance, Capacity, and Program Delivery

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.