Public Health Improvement Training (PHIT) Reaction Survey

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-1050 Public Health Improvement Training (PHIT) Reaction Survey Form and Instruction
0920-1050 PHIT End of Session Survey - Web version Attachment B - PHIT Session Survey Instrument _Web Version.docx Form and Instruction
0920-1050 PHIT End of Training Survey - Web version Attachment D- PHIT End of Training Survey Instrument _Web Version.docx Form and Instruction
Attachment A - PHIT-Session Survey Instrument 5.8.19.docx PHIT End of Session Survey - Word version IC Document
Attachment C - PHIT- End of Training Survey Instrument 5.8.docx PHIT End of Training Survey - Word version IC Document
Attachment E - Individual Session Survey Web App Invite and Reminder.docx Individual Session Survey Web App Invite and Reminder IC Document
Attachment F - End of Training Survey Email Invite.docx End of Training Survey - Email Invite IC Document
Attachment G - End of Training Survey Reminder.docx End of Training Survey - Reminder IC Document
PHIT Reaction Survey_Request for Approval_0920-1050 Customer Service GenIC.docx GenIC Request IC Document

Information Collection (IC) Details

IC Title:	Public Health Improvement Training (PHIT) Reaction Survey	Agency IC Tracking Number:	0920-1050-19AWZ

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	0920-1050	PHIT End of Session Survey - Web version	Attachment B - PHIT Session Survey Instrument _Web Version.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1050	PHIT End of Training Survey - Web version	Attachment D- PHIT End of Training Survey Instrument _Web Version.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
PHIT End of Session Survey - Word version	Attachment A - PHIT-Session Survey Instrument 5.8.19.docx	05/28/2019
PHIT End of Training Survey - Word version	Attachment C - PHIT- End of Training Survey Instrument 5.8.docx	05/28/2019
Individual Session Survey Web App Invite and Reminder	Attachment E - Individual Session Survey Web App Invite and Reminder.docx	05/28/2019
End of Training Survey - Email Invite	Attachment F - End of Training Survey Email Invite.docx	05/28/2019
End of Training Survey - Reminder	Attachment G - End of Training Survey Reminder.docx	05/28/2019
GenIC Request	PHIT Reaction Survey_Request for Approval_0920-1050 Customer Service GenIC.docx	05/28/2019

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