Approaching accreditation health departments

Public Health Accreditation Board (PHAB): Assessment of Processes and Outcomes

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1295 can be found here:

Documents and Forms

Document Name Document Type
Approaching accreditation health departments Form
Approaching accreditation health departments AttachmentI_Survey4-Screenshot.pdf Form
AttachmentR_Survey4-Invitation.docx Survey invitation IC Document
AttachmentW_Survey4-Reminder.docx Survey reminder IC Document

Information Collection (IC) Details

IC Title:	Approaching accreditation health departments	Agency IC Tracking Number:

Is this a Common Form? No		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	none	Approaching accreditation health departments	AttachmentI_Survey4-Screenshot.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	814	814

Documents for IC

Title	Document	Date Uploaded
Survey invitation	AttachmentR_Survey4-Invitation.docx	12/30/2019
Survey reminder	AttachmentW_Survey4-Reminder.docx	12/30/2019

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