Information Collection

Environmental Health Workforce Current and Emerging Challenges Assessment

IC 231592 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⚠️ Notice: This information collection may be referencing outdated material.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
Form 0920-0879 Environmental Health Workforce Current and Emerging Challenges Assessment	Form and Instruction
0920-0879 Recruitment Instrument - State Health Department EH Prof Attachment C. Recruitment Instrument-Web Version.docx	Form and Instruction
0920-0879 Recruitment Instrument - Tribal Health Department EH Pro Attachment C. Recruitment Instrument-Web Version.docx	Form and Instruction
0920-0879 Recruitment Instrument - Local Health Department EH Prof Attachment C. Recruitment Instrument-Web Version.docx	Form and Instruction
0920-0879 Recruitment Instrument - Territorial Health Department E Attachment C. Recruitment Instrument-Web Version.docx	Form and Instruction
0920-0879 Focus Group Facilitation Guide - STLT EH Professionals Attachment D. Facilitation Guide_REVISED.docx	Form and Instruction
Attachment A. Respondent Breakdown.docx Respondent Breakdown	IC Document
Attachment E. Assessment Topics.docx Assessment Topics	IC Document
Attachment F. Information Collection Crosswalk.docx Information Collection Crosswalk	IC Document
Attachment G. Notification Email.docx Notification Email	IC Document
Attachment H. Reminder Email.docx Reminder Email	IC Document
Attachment I. Confirmation Email.docx Confirmation Email	IC Document
Attachment J. Confirmation Call.docx Confirmation Call	IC Document
UNCOVER-EH-SSA.docx Supporting Statement A	IC Document
UNCOVER-EH-SSB_REVISED.docx Supporting Statement B 31MAY2018	IC Document

IC Title:

Environmental Health Workforce Current and Emerging Challenges Assessment

Agency IC Tracking Number:

0920-0879-18AGJ

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	0920-0879	Recruitment Instrument - State Health Department EH Professional	Attachment C. Recruitment Instrument-Web Version.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0879	Recruitment Instrument - Tribal Health Department EH Professional	Attachment C. Recruitment Instrument-Web Version.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0879	Recruitment Instrument - Local Health Department EH Professional	Attachment C. Recruitment Instrument-Web Version.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0879	Recruitment Instrument - Territorial Health Department EH Professional	Attachment C. Recruitment Instrument-Web Version.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0879	Focus Group Facilitation Guide - STLT EH Professionals	Attachment D. Facilitation Guide_REVISED.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: 1,036

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	1,036	1,036
Annual IC Time Burden (Hours)	177	177
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Respondent Breakdown	Attachment A. Respondent Breakdown.docx	05/31/2018
Assessment Topics	Attachment E. Assessment Topics.docx	05/31/2018
Information Collection Crosswalk	Attachment F. Information Collection Crosswalk.docx	05/31/2018
Notification Email	Attachment G. Notification Email.docx	05/31/2018
Reminder Email	Attachment H. Reminder Email.docx	05/31/2018
Confirmation Email	Attachment I. Confirmation Email.docx	05/31/2018
Confirmation Call	Attachment J. Confirmation Call.docx	05/31/2018
Supporting Statement A	UNCOVER-EH-SSA.docx	05/31/2018
Supporting Statement B 31MAY2018	UNCOVER-EH-SSB_REVISED.docx	05/31/2018

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