OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

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

ICR 202503-0920-007 · OMB 0920-1175 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-1175 PHA Impact Follow Up - (RedCap form) (New form) Form and Instruction Unchanged Repair queued
Form 0920-1175 PHA Impact Follow Up - (RedCap form) (New form) Form and Instruction Unchanged Repair queued
Form 0920-1175 Performance Measures- Unique Form and Instruction Unchanged Available
Form 0920-1175 Performance Measures- Unique Form and Instruction Unchanged Repair queued
Form 0920-1175 Standardized Web Statistics - Codebook Form and Instruction Unchanged Available
Form 0920-1175 Standardized Web Statistics - Codebook Form and Instruction Unchanged Repair queued
Form 0920-1175 Data Dictionary- State Biomonitoring Data Form and Instruction Modified Repair queued
Form 0920-1175 Data Dictionary- State Biomonitoring Data Form and Instruction Modified Repair queued
Form 0920-1175 Outreach & Communication Plan Template with Instructions Form and Instruction Unchanged Available
Form 0920-1175 Outreach & Communication Plan Template with Instructions Form and Instruction Unchanged Repair queued
Form 0920-1175 Publilc Health Action Report - Existing Awardees Form and Instruction Unchanged Repair queued
Form 0920-1175 Publilc Health Action Report - Existing Awardees Form and Instruction Unchanged Repair queued
Form 0920-1175 Environmental Public Health Tracking Work Plan Template Form and Instruction Unchanged Repair queued
Form 0920-1175 Environmental Public Health Tracking Work Plan Template Form and Instruction Unchanged Repair queued
Form 0920-1175 Metadata Sample Content Form and Instruction Unchanged Available
Form 0920-1175 Metadata Sample Content Form and Instruction Unchanged Repair queued
Form 0920-1175 Data Dictionary for Data Submission -- Labs Radon Data Form and Instruction Unchanged Available
Form 0920-1175 Data Dictionary for Data Submission -- Labs Radon Data Form and Instruction Unchanged Repair queued
Form 0920-1175 Data Dictionary- Hospitalizations Form and Instruction Modified Available
Form 0920-1175 Data Dictionary- Hospitalizations Form and Instruction Modified Repair queued
Form 0920-1175 Data Dictionary - Emergency Department (ED) Visits Form and Instruction Modified Available
Form 0920-1175 Data Dictionary - Emergency Department (ED) Visits Form and Instruction Modified Repair queued
Form 0920-1175 Data Dictionary – Drinking Water (Community Monitoring) Form and Instruction Unchanged Available
Form 0920-1175 Data Dictionary – Drinking Water (Community Monitoring) Form and Instruction Unchanged Repair queued
Form 0920-1175 Environment Public Health Tracking -- Childhood Blood Lead Poisoning Form and Instruction Unchanged Available
Form 0920-1175 Environment Public Health Tracking -- Childhood Blood Lead Poisoning Form and Instruction Unchanged Repair queued
Form 0920-1175 Data Dictionary – Birth Defects (Prevelance) Form Form and Instruction Modified Available
Form 0920-1175 Data Dictionary – Birth Defects (Prevelance) Form Form and Instruction Modified Repair queued
0920-1175 Change Request Memo - EO14168.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-03-06 Repair queued
0920-1175 Change Request Memo - EO14168.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-03-06 Repair queued
Att6 CDC-RFA-EH17-1702.pdf Supplementary Document Uploaded 2023-07-06 Available
Att6 CDC-RFA-EH17-1702.pdf Supplementary Document Uploaded 2023-07-06 Repair queued
Att10 Data Management Processes.pdf Supplementary Document Uploaded 2023-07-06 Available
Att10 Data Management Processes.pdf Supplementary Document Uploaded 2023-07-06 Repair queued
Att9 NCDM Requirements.pdf Supplementary Document Uploaded 2023-07-06 Available
Att9 NCDM Requirements.pdf Supplementary Document Uploaded 2023-07-06 Missing upstream
Att8 Funding Determination.pdf Supplementary Document Uploaded 2023-07-06 Repair queued
Att8 Funding Determination.pdf Supplementary Document Uploaded 2023-07-06 Repair queued
Att7 Environ PH Trckg 2023 Revision PIA.pdf Supplementary Document Uploaded 2023-07-06 Repair queued
Att7 Environ PH Trckg 2023 Revision PIA.pdf Supplementary Document Uploaded 2023-07-06 Repair queued
Att3 NOFO CDC-RFA-EH22-2202.pdf Supplementary Document Uploaded 2023-07-06 Repair queued
Att3 NOFO CDC-RFA-EH22-2202.pdf Supplementary Document Uploaded 2023-07-06 Repair queued
Att2 Environ PH Trckg 60 day FRN publication.pdf Supplementary Document Uploaded 2023-07-06 Available
Att2 Environ PH Trckg 60 day FRN publication.pdf Supplementary Document Uploaded 2023-07-06 Repair queued
Att1_PHSA Section 243&247.docx Supplementary Document Uploaded 2020-04-27 Available
Att1_PHSA Section 243&247.docx Supplementary Document Uploaded 2020-04-27 Repair queued
0 - Environ PH Trckg 2023 Revision SSB.docx Supporting Statement B Uploaded 2023-07-06 Available
0 - Environ PH Trckg 2023 Revision SSB.docx Supporting Statement B Uploaded 2023-07-06 Repair queued
0 - Environ PH Trckg 2023 (REV) SSA.docx Supporting Statement A Uploaded 2023-07-17 Available
0 - Environ PH Trckg 2023 (REV) SSA.docx Supporting Statement A Uploaded 2023-07-17 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
260973 PHA Impact Follow Up - (RedCap form) (New form) Form and Instruction Unchanged
260973 PHA Impact Follow Up - (RedCap form) (New form) Form and Instruction Unchanged
241554 Performance Measures- Unique Form and Instruction Unchanged
241554 Performance Measures- Unique Form and Instruction Unchanged
222657 Standardized Web Statistics - Codebook Form and Instruction Unchanged
222657 Standardized Web Statistics - Codebook Form and Instruction Unchanged
222656 Data Dictionary- State Biomonitoring Data Form and Instruction Modified
222656 Data Dictionary- State Biomonitoring Data Form and Instruction Modified
222654 Outreach & Communication Plan Template with Instructions Form and Instruction Unchanged
222654 Outreach & Communication Plan Template with Instructions Form and Instruction Unchanged
222652 Publilc Health Action Report - Existing Awardees Form and Instruction Unchanged
222652 Publilc Health Action Report - Existing Awardees Form and Instruction Unchanged
222650 Environmental Public Health Tracking Work Plan Template Form and Instruction Unchanged
222650 Environmental Public Health Tracking Work Plan Template Form and Instruction Unchanged
222649 Metadata Sample Content Form and Instruction Unchanged
222649 Metadata Sample Content Form and Instruction Unchanged
222648 Data Dictionary for Data Submission -- Labs Radon Data Form and Instruction Unchanged
222648 Data Dictionary for Data Submission -- Labs Radon Data Form and Instruction Unchanged
222646 Data Dictionary- Hospitalizations Form and Instruction Modified
222646 Data Dictionary- Hospitalizations Form and Instruction Modified
222533 Data Dictionary - Emergency Department (ED) Visits Form and Instruction Modified
222533 Data Dictionary - Emergency Department (ED) Visits Form and Instruction Modified
222532 Data Dictionary – Drinking Water (Community Monitoring) Form and Instruction Unchanged
222532 Data Dictionary – Drinking Water (Community Monitoring) Form and Instruction Unchanged
222531 Environment Public Health Tracking -- Childhood Blood Lead Poisoning Form and Instruction Unchanged
222531 Environment Public Health Tracking -- Childhood Blood Lead Poisoning Form and Instruction Unchanged
222530 Data Dictionary – Birth Defects (Prevelance) Form Form and Instruction Modified
222530 Data Dictionary – Birth Defects (Prevelance) Form Form and Instruction Modified
ICR Details
StatusActive
Agency/SubagencyHHS/CDC
OMB Control No0920-1175
Type of Information CollectionNo material or nonsubstantive change to a currently approved collection
Previous ICR Reference No202306-0920-006
Agency Tracking No0920-25-0034
Date Submitted to OIRA2025-03-28
Requested Expiration Date1969-12-31