[NCEH] EHS-Net Outbreak Prevention & Response Practices Study

Environmental Health Specialists Network (EHS-NET) Program

Documents and Forms

Document Name Document Type
[NCEH] EHS-Net Outbreak Prevention & Response Practices Study Form and Instruction
Manager Interview A3 Manager InterviewFINAL_revOS.docx Form and Instruction
Worker Interview A4 Worker InterviewFINAL_revOS.docx Form and Instruction
Observation A5 ObservationFINAL_revOS.docx Form and Instruction
Recruitment Script A6 - Recruitment Script_RevOS.docx Form and Instruction
A1 Auth Legislation.docx Authorizing Legislation IC Document
A2 EHS-Net Publications.docx EHS-NET Publications IC Document
7479 Exempt Research Approval.pdf Research Determination IC Document
OPRStudyProtocol_revOS 20240118.docx Study Protocol IC Document
EHS-Net OPR SSAv2_OS_final.docx SSA IC Document
EHS-Net OPR SSB_revOS.docx SSB IC Document

Information Collection (IC) Details

IC Title:	[NCEH] EHS-Net Outbreak Prevention & Response Practices Study	Agency IC Tracking Number:	0920-0792-24CE

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
Form and Instruction	n/a	Manager Interview	A3 Manager InterviewFINAL_revOS.docx	Yes	No	Fillable Fileable
Form and Instruction	n/a	Worker Interview	A4 Worker InterviewFINAL_revOS.docx	Yes	No	Fillable Fileable
Form and Instruction	n/a	Observation	A5 ObservationFINAL_revOS.docx	Yes	No	Fillable Fileable
Form and Instruction	n/a	Recruitment Script	A6 - Recruitment Script_RevOS.docx	Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,110	Number of Respondents for Small Entity: 1,055

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,110	2,110
Annual IC Time Burden (Hours)	549	549
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Authorizing Legislation	A1 Auth Legislation.docx	01/24/2024
EHS-NET Publications	A2 EHS-Net Publications.docx	01/24/2024
Research Determination	7479 Exempt Research Approval.pdf	01/24/2024
Study Protocol	OPRStudyProtocol_revOS 20240118.docx	01/24/2024
SSA	EHS-Net OPR SSAv2_OS_final.docx	01/24/2024
SSB	EHS-Net OPR SSB_revOS.docx	01/24/2024

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