Privacy Checklist

Privacy Act Checklist

OMB control # 0920-0995

Performance Measurement for STD Prevention

Does the data collection involve collecting sensitive or personally identifiable information?

No. Respondents are providing business contact information and not personally identifiable information. The NNPTC HPAT (Att 3) is the only instrument that collects categories of information in identifiable format from individual respondents such as: name, work mailing address, work phone numbers, work email address, work organization, race and ethnicity. These identifiable NNPTC HPAT data elements are needed to send information about the training or technical assistance for which they have registered, send electronic invitations to complete evaluation instruments, and identify county of workplace and type of employment setting to analyze reach. The identifiable information collected by the National Evaluation Center is stored behind firewalls at the NEC in password protected files and are available only to authorized users of the NEC. As noted above, no IIF is provided to the DSTDP.

Describe how personal information will be maintained and who will have access to it.

N/A

How long will sensitive or personal information be maintained? This information is crucial. If sensitive information is maintained for even one day, the Privacy Act will apply and we will have to provide language in the clearance package.

N/A

Will the collected information be covered by the appropriate CDC Assurance of Confidentiality?

N/A

If identifiable information will be filed and retrieved by the name of the individual:

N/A

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