Public Health Improvement Training 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⚠️ Notice: This information collection may be referencing outdated material.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
Attachment A - PHIT-Session Survey Instrument 5.8.19.docx Other-WORD
Attachment C - PHIT- End of Training Survey Instrument 5.8.docx Other-WORD
Attachment E - Individual Session Survey Web App Invite and Reminder.docx Instruction
0920-1050 NNPHI (Public Health Improvement Training Reaction Surve Attachment B - PHIT Session Survey Instrument _Web Version.docx Form and Instruction
0920-1050 NNPHI (PHIT End of Training Survey) Attachment D- PHIT End of Training Survey Instrument _Web Version.docx Form and Instruction
Attachment G - End of Training Survey Reminder.docx Att G_End of Training Survey Email Reminder IC Document
Attachment F - End of Training Survey Email Invite.docx Att F_End of Training Survey Invitation IC Document
PHIT Reaction Survey_Request for Approval_0920-1050 Customer Service GenIC.docx Request for Approval IC Document

Information Collection (IC) Details

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

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD			Attachment A - PHIT-Session Survey Instrument 5.8.19.docx	No		Paper Only
Form and Instruction	0920-1050	NNPHI (Public Health Improvement Training Reaction Survey)	Attachment B - PHIT Session Survey Instrument _Web Version.docx	Yes	Yes	Fillable Fileable
Other-WORD			Attachment C - PHIT- End of Training Survey Instrument 5.8.docx	No		Paper Only
Form and Instruction	0920-1050	NNPHI (PHIT End of Training Survey)	Attachment D- PHIT End of Training Survey Instrument _Web Version.docx	Yes	Yes	Fillable Fileable
Instruction			Attachment E - Individual Session Survey Web App Invite and Reminder.docx	No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att G_End of Training Survey Email Reminder	Attachment G - End of Training Survey Reminder.docx	06/13/2019
Att F_End of Training Survey Invitation	Attachment F - End of Training Survey Email Invite.docx	06/13/2019
Request for Approval	PHIT Reaction Survey_Request for Approval_0920-1050 Customer Service GenIC.docx	06/13/2019

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