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Intensive Complete Post-Course Evaluation
[NCHHSTP] National Network of Sexually Transmitted Disease Clinical Prevention Training Centers (NNPTC)
OMB: 0920-0995
IC ID: 251728
OMB.report
HHS/CDC
OMB 0920-0995
ICR 202211-0920-008
IC 251728
( )
Documents and Forms
Document Name
Document Type
Intensive Complete Post-Course Evaluation
Form and Instruction
Intensive Complete Post-Course Evaluation (paper option)
Att 13_Intensive-Post Course Evaluation-2022- 11.22.22.docx
Form and Instruction
Intensive Complete Post-Course Evaluation (paper option)
Att 13_Intensive-Post Course Evaluation-2022- 11.22.22.docx
Form and Instruction
Intensive Complete Post-Course Evaluation (electronic op
Att 14_Intensive Post-Course Evaluation 2022- Screenshot.pdf
Form and Instruction
Intensive Complete Post-Course Evaluation (electronic op
Att 14_Intensive Post-Course Evaluation 2022- Screenshot.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Intensive Complete Post-Course Evaluation
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
Intensive Complete Post-Course Evaluation (paper option)
Att 13_Intensive-Post Course Evaluation-2022- 11.22.22.docx
No
Paper Only
Form and Instruction
None
Intensive Complete Post-Course Evaluation (electronic option)
Att 14_Intensive Post-Course Evaluation 2022- Screenshot.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
300
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
95 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
300
0
0
0
0
300
Annual IC Time Burden (Hours)
50
0
0
0
0
50
Annual IC Cost Burden (Dollars)
0
0
0
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.