Assessment of STLT Public Health Agencies to Guide the Update of CDC/ATSDR Cancer Cluster Guidelines

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

OMB: 0920-0879

IC ID: 242670

Documents and Forms
Document Name
Document Type
Form
Other-Focus group guide
Form
Form
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Assessment of STLT Public Health Agencies to Guide the Update of CDC/ATSDR Cancer Cluster Guidelines 0920-0879-20QF
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Assessment -word AttA_Assessment_WordVersion.docx Yes Yes Fillable Fileable
Form none Assessment - web AttB_Survey_WebVersion.pdf Yes Yes Fillable Fileable
Other-Focus group guide AttC_FocusGroupFacilitatorsGuide.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

3,190 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,190 0 3,190 0 0 0
Annual IC Time Burden (Hours) 1,715 0 1,715 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Invitation email AttD_InvitationEmail.docx 07/13/2020
Reminder email AttE_ReminderEmail.docx 07/13/2020
Focus group reminder AttF_FocusGroupDiscussion_ReminderEmail.docx 07/13/2020
Regions AttG_ATSDR Regions.docx 07/13/2020
Supporting statement A CCGDLNS-SSA.docx 07/13/2020
Supporting statement B CCGDLNS-SSB.docx 07/13/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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