0920-1175 Performance Measurses - Unique

[NCEH] Environmental Public Health Tracking Network (Tracking Network)

Att5F Performance Measures (RedCap Form)

OMB: 0920-1175

Document [pdf]
Download: pdf | pdf
01234567658	
5641535
	6	3
	4658	
1	253	
5641535
	3
	43653	  ! "

.$#/%$*3$1,4#$,*5*62)74$
#$%&#'()'

9

#$%&#'()'*+$,-

38

43653

9
:34	52	23846;
615	1<	2
	8;8	14	66

6158	22438832
=
>40?$#*&/*'1-1*@1A,*&#*B)0)-1-)&2,*1''#$,,$'
=
C	8
	;41623	3

DEFGHIJKLMNOLMFHP

Q$,%#)A-)&2*&/*'1-1*@1A,*&#*B)0)-1-)&2,*1''#$,,$'
C	8
	;41623	3

:34	52	23846;
615	1<	65
345	;4184	
66
638	2331;32R65<14 32R14
6;4132	S	5S868	1<	4658	2
83
89
=
>40?$#*&/*)2-$#21B*A#&@#10*1%-)T)-)$,*'$T$B&A$'U*)2/�$'U*&#
)0A#&T$'*?V*121BV,),*&/*+#1%W)2@*'1-1
=
C	8
	;41623	3

DEFGHIJKLMNOLMFHP

01234567589
8
6484


37557512


 !"!#!!$"%!#%
#&"'!$(!#)!)*"
!
+
,-.14
8
6484


37557512
/141
011186102
5984102
84
564810

714
34
3459
0
7
/141
-210
78
5019755

0526486847589
7115

613710
686-1
7589

789:;<=>?@AB?@9;CA:?DA=E>@9F;A?>G=H=G=;IAGJ?GAK;<;A@=IG;FA?LMH;N



01234567589
8
6484


37557512
/O141

0526486847589
7115

613710
686-1
7589
/
2
501975P10

90Q84

00412210


R
S"TUV!"!

R
 #$!!!"!U!)U"T!!

12345689
8
35
8




1234568953

.

56/

50


1234568965

655
5



!"#$%&'()*+,)*#%-

!"#$%&'()*+,)*#%-

!"#$%&'()*+,)*#%-

123444567248494349:47
42345494
;8
0234568965
50
80

0.865<=4

3550>

0
80956505


!"#$%&'()*+,)*#%-



?
3
5@8
02345689
5055
.056
80
260>
65
50
80

0.86
5<=4



!"#$%&'()*+,)*#%-

12438AB9494994

1234267897

34834
38
433338
6
73436
373926

7
 !"#$%#

&$'(!)*+,$#)#-##(
&$'(..&#$

/012134562254764568829:

;
<*$=$$'!>

;
?@#A#))#%#"@>B!'#$!#$*###)C$%DA
!)"!!"$%EF&B!)@#B%"!)'%"#$)>$GB$$""##?HIH
#J!##)F
KL78M678NO
43
NN6687L2348867
3

97

/PQR1ST3625U62Q1:

 !"#$%#

KL78M3V36687
WX
L78ML
2348867
3
97Y
 !"#$%#

/PQR1ST3625U62Q1:

?@#A#) !)#)$%&$'(!)*$!)!)* !"#"$#$)"%'$%@%!'B#$%B
,(A'#$)"$)#Z$)")@#A$!)##F

12345789
2
14734772
!"#$"

23943332345789
2
434734522953
3477

%&'()*+,-./0-.')1

%&'()*+,-./0-.')1

!"#$"

67"#8!!"98:"8""$#"!#9";<9"9#889$!"!"9$=
8>#"8"$#888>:"8"?"#7$@8>"#A9B#88>
#CA"9;D
E89
2
433354335F82347287
27

%&'()*+,-./0-.')1

!"#$"

G3272
327823433
!"#$"

E89
2
433
282754777
227
!"#$"

%&'()*+,-./0-.')1

01234567589
8
41268921
6
9959

37557512





!"!#$%!&'

()!$!"!*!$%
"!+$!$'"$!#$,!&'
F
()!$!"!!%!$!-%
.'/"!/)'/!!"$!#$,!&
'
0
12
01234567589
8
731
78846483122
84
5
7
6561591
193
9316197
5661619715
7689
386617589
8

512345675898

5557589

9152
41
715
78
731
788464831224193
9316197
:5

661
4
;18:2
<5557589
=8

987314
51234567589
;8>
:5

661
4
78
512345;1
731
91>7
788464831224193
93161972
?931


788246483122124193
93161972
3
1
;119
19714158
1
1
731

27
51234567589
;8>
;
9@2
A352
:5
59553
71
73141

41
98
B47314
788246483122124193
93161972
78
512345;120


CDE$E!%!$!$!

1234678669
364

4448


!""#"$%&
!"'$%&
()*
(! #"+,-.
((/",-)"01"2$%&
(3,4#-)
(-)"0$0",(5$0"
6#"0+
7"0+
+,-#8-$-939+*9%.)":2$".
+,-#8-$-939+*9%.)":2(
!""0
+,-#8-$-939+*9%.)":2;"
<)

=>?@?ABCDE?F

G7HI84H8234678669
364

4448J394
4K4
LM4N


O8L36P448
K64
848669
364

4448
36PLK4Q


O8
8W4L84K89L74294K64
84
8669
364

4448KK4

Q


R.'(
+"'(
$"
%"),3")/)(-/

=>?@?ABCS@@CBTSBCSUU@VF

! #"
%#"0,;"
$".
;X"
("",-)"0
1"

=>?@?ABCDE?F

12456789
9
5
875668
9
59
55

755

9
55
5

756
87566565

755
6555
5
585
555656789
9

29699
97558585

8586
87566565

755
65678952
 !"#$%&'()*'+,!*

-8.6
/
550

123& $,*#*

01234567658	
5641535
	6	3
	4658	
1	253	
5641535
	3
	43653	
  ! "

.$#/%$*3$1,4#$,*5&26)-4')217
#$%&#'()'

9

#$%&#'()'*+$,-

38

43653
9

:34	52	68
	1;	4658	15
35
	438	;14	<6	41
653	23846=
63	5>838	43
152
329
?
@$7$%-*177*%&2-$2-*1#$1,A)2')%1-&#,*/&#*BC)%C*D&4*%&2'4%#&4-)2$*1217D,),E
?
F	8
	=41623	3

	64	G6
>		68
146	64	G6
>
	64	G6
>		55	0 HI	J33
	64	G6
>		653	4
63	0 HI">8	13
38
14>	
5242
	64	G6
>		:
615	635
	64	G6
>

52428	:G"
	64	G6
>		:
615	635
	64	G6
>

52428	:G"
	64	G6
>		K7153>8	13	38
14>

5242
	8
		
34835>	3=4
35
	L686
8	;14
8

	8
		18=6
67
6158	;14	8

	M64
	3;3
8		43353	1;	M64
	3;3
8
	534		534	N562353
	534		62112	534	N562353
	415	0151O623	16815658		K	16815658
014
6
>
	415	0151O623	16815658		
34835>
3=4
35
	L686
8	;14	K	16815658

123456756589
59
56965153
1532
123456756589
59
56965
9292956
53
123456756589
159
5696
123456756589
59
569653
85
3
51
1 9
 55
!2
59
5696"662#55
!2

!
1 9
 55
!2
59
5696#55
!2
!
4$
#93 15 53
1 9
 55
!2
59
569653$26
5
96
"
1 35694
395623$9
53
3
36$236%9
9
531
1 35694
395623$9
53
3
5
9292956
531
1921 26&2'232
(6

(
36$236%9
9
53(
1921 26&2'232
(6

(
5
9292956
53(
1921 26!$9
2

1921 26&2'232
(6

(
)323
396*96+23"3
69!26
5692
5295685
3
396*96+23"3296!26
5692
5295685
3
396*96+2315496
2
9,,-26
,,.
!
26
56925295685
3
396*96+239,$8$ 22
!26
56925295685
3
396*96+239
96956#$35

!
26
56925295685
3
396*96+23/932!26
5692
5295685
3
396*96+2349+230

396*96+23)32 53561!
26
56925295685
3

12345346789
223
2
9
4


84
9
493889342

12345346789
22843

849
4938
89342


82913
8
 !925
3983"8934#2

829$998
5

82913
8
 !925
3983"8934#2

829$998
5
%84%84
9#2!989

%
2
93
 &329'9

(
29339)
%
2
93
 &329'9

*&329*
369
%
2
93
 &329'9

+29839)
%
2
93
 &329'9

2
89239)
%
2
93
 &329'9

!
%89389
&329
'9
2
,
-./0123450/6782482/9549:;<8=<69275:/<:/:4>4624=?/@>49:4/=4:65[:4:/2392/=<:67\45/@922458:?/<=482<.[
@72482<9>/6786458:?/75/72345]<:4/@57\<=4:/84]/<8:<^32:/75
:7>Y2<78:/.75/48\<578Z4829>/349>23
,
_923
8


E`aHbPGcJdefabS

1234567967
25
533
723
5799
7

!"#!

$%&'!"(()
*+,-,./01/233/405678

9:!"( !;(<:=;(>"( ?!"#=!?(!"!"#=!""
9:!?!;!(<!;!('P":#;#>""#":#!"#@
Q339479D594959D732
9G
!"#!

H!
9

12342568595

625
293363242539322
32
32

 !"#$!%  &#' %!( )*#+,)-!+&*,#)./,'!0,*/!)#*/ +
1$+,.%,2*,#)3


6
3

46923555


7&. !. &2*!*/ !)$(8 +!#9!9$)% %!( )* .:


;

46923555


<=!> .2+,8 !"#$+!( )*#+,)-!+&*,#)./,'!0,*/!9$)% %!( )* =

46923555


7&. !. &2*!*/ !)$(8 +!#9!$)9$)% %!( )* .:

46923555

;?@322654
ABCDCEFGHFIJJFKGLMNO

P

12456789
5
8589859699

55552
!"#$%"&'%

()*+!$%&#,#,./010234536773849:;<

=2456789
5
8589859699

55552
!"#$%"&'%

()*+!$%&#,#,./010234536773849:;<

>
?&,%@#

AB%C'#C&,$$%D##!,!E#,%,&'&,$%F%,&'&,%>
AB%G%D%,&,$$%D##!,!E&,%@#+!H#,-!%$D%@%&'@
$#&##%>

124567896

658578

8
97879
567896

658578779
57859
69579779
567896

69578


5

95692
78558796
567896

6585787799
5

956798799
6
78679897
567896

69578

2895
567896

5999898796995979
5
7
567896

658578779958 2!
8579
79695698"6796
567896

79
692

230%)1/$40*(5/*'6-)$7*805-90(-+5

:;<$=+*.'$*/%0-5-58
>?@A@BCDECFGGCHDIJKL

#$%&'($)*+,-./$,01&/

M997797
9
567896

6585782
#$%&'($)*+,-./$,01&/

NO796O7
9
567896

658578

9979
95
9
9
692
#$%&'($)*+,-./$,01&/

P57
7999985998767

567896

658578Q
#$%&'($)*+,-./$,01&/

M997795857

567896

2
#$%&'($)*+,-./$,01&/

7(6/*

123467849
634789
2623373
67849
86834
34844336393
43348332


+(
,$

 !"#$%&'(%)*(

-3
4392.83348968229
634789
68.86834/
 !"#$%&'(%)*(

0/-
63478912
83
682
13
9
63478947
.33336333
.3673
46
9
63478922
83
682686343
/5784
888
63
6733
326739
6347894623483/

6789$#' #()&:&:;
<=>?>@ABCADEEAFBGHIJ

 !"#$%&'(%)*(

K2LM6
64
N2L9363

O:P$"*(!(


File Typeapplication/pdf
File TitleModernizing Environmental Public Health...veillance (CDC-RFA-EH22-2202) _ REDCap
Authorqcu2
File Modified2023-05-22
File Created2022-10-20

© 2024 OMB.report | Privacy Policy