0920-0909 Evaluation Data Form

CDC Diabetes Prevention Recognition Program (DPRP)

Att 4B DPRP Data Elements for Eval_2021 Standards_11-30-20.csv

OMB: 0920-0909

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0909 can be found here:

2024-04-24 - Revision of a currently approved collection

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ORGCODE,PARTICIP,COHORTID,COACHID,ENROLL-MOT,ENROLL-HC,PAYERSOURCE,STATE,GLUCTEST,A1C,GDM,RISKTEST,AGE,ETHNIC,AIAN,ASIAN,BLACK,NHOPI,WHITE,SEX or GENDER,HEIGHT,EDU,DMODE,SESSTYPE,DATE,WEIGHT,PA

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