NPIN Initial Questionnaire Telephone Script for New Organizations

[NCHHSTP] Resources and Services Database of the National Prevention Information Network

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0255 can be found here:

Documents and Forms

Document Name Document Type
NPIN Initial Questionnaire Telephone Script for New Organizations Form and Instruction
NPIN Initial Questionnaire Telephone Script Att 3A_NPIN Initial Questionnaire Telephone Script.docx Form and Instruction
NPIN Initial Questionnaire Telephone Script Att 3A_NPIN Initial Questionnaire Phone Script with MpoxVaccineTesting.docx Form and Instruction

Information Collection (IC) Details

IC Title:	NPIN Initial Questionnaire Telephone Script for New Organizations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	None	NPIN Initial Questionnaire Telephone Script	Att 3A_NPIN Initial Questionnaire Phone Script with MpoxVaccineTesting.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 800	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	800	400	400
Annual IC Time Burden (Hours)	93	39	54
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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