Record Abstraction (STD Clinics)

[NCHHSTP] The STD Surveillance Network (SSuN)

OMB: 0920-1072

IC ID: 232378

Information Collection (IC) Details

View Information Collection (IC)

Record Abstraction (STD Clinics) 0920-1072
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1072 SSuN Data Elements Att5_DataElements_DataDisctionary.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

40 0
   
State, Local, and Tribal Governments
 
   100 %

  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 240 0 229 0 0 11
Annual IC Time Burden (Hours) 960 0 696 0 0 264
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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