Information Collection

Public Health Improvement Training Reaction Survey

IC 236453 under ICR 201902-0920-022 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.