[PHIC] Data Collection for CDC Fellowship Programs

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-1163 PHAP Program Separation Survey	Form and Instruction	New	Available
Form 0920-25-0163 PHAP HHS NGO	Form	New	Repair queued
PHAP Host Site Supervisor Survey	Form and Instruction	New	Available
Form 0920-25-0146 EIS Survey	Form	New	Available
Form 0920-25-0146 LLS Survey	Form	New	Repair queued
Form 0920-25-0007 2025 EIS Sup Ex Surv	Form	New	Available
Form 0920-25-0007 2025 EIS Sup Surv	Form	New	Available
2025 SAF Exit Survey	Form and Instruction	New	Available
Form 0920-25-0006 Att_5_2025 LLS Sup ExSurv	Form	Unchanged	Available
Form 0920-25-0006 Att_1_2025 LLS Sup Surv	Form	Unchanged	Available
Form 0920-25-0006 [PHIC] 2025 LLS Host Site Survey	Form	Unchanged	Repair queued
Form 0920-1163 2025 EEP Supervisor Evaluation of Student and Program Survey	Form and Instruction	Unchanged	Repair queued
Form 0920-1163 [PHIC] 2025 EEP Supervisor Survey	Form and Instruction	Unchanged	Repair queued
2024 CDC SAF Summer Course Survey	Form and Instruction	Unchanged	Available
[PHIC] 2024 CDC Science Ambassador Fellowship Summer Course Survey	Form and Instruction	Unchanged	Repair queued
Form 0920-24GG 2024 LLS Supervisor Exit Survey	Form	Unchanged	Available
Form 0920-24GG LLS Supervisor Survey	Form	Unchanged	Available
Form 0920-24GG [PHIC] LLS supervisor surveys	Form	Unchanged	Available
Form 0920-24GH 2024 EIS Supervisor Exit Survey	Form	Unchanged	Available
Form 0920-24GH 2024 EIS Supervisor Survey	Form	Unchanged	Available
Form 0920-24GH [PHIC] EIS supervisor surveys	Form	Unchanged	Repair queued
Form 0920-1163 2024 CDC SAF Focus Group Availability	Form and Instruction	Unchanged	Available
Form 0920-1163 2024 CDC Science Ambassador Fellowship Exit Survey	Form and Instruction	Unchanged	Available
Form 0920-1163 [PHIC] SAF Exit Survey and Focus Groups	Form and Instruction	Unchanged	Repair queued
Form 0920-1163 Science Ambassador Fellowship (SAF) Alumni Survey	Form and Instruction	Unchanged	Available
Form 0920-1163 [PHIC] Science Ambassador Fellowship (SAF) Alumni Survey (2023)	Form and Instruction	Unchanged	Repair queued
Form 0920-1163 [Epidemic Intelligence Service/Laboratory Leadership Service] Alumni Survey	Form and Instruction	Unchanged	Available
Form 0920-1163 [PHIC] EIS LLS alumni survey 2023	Form and Instruction	Unchanged	Repair queued
EEP Alumni Survey	Form and Instruction	Unchanged	Available
[PHIC] Epidemiology Elective Program (EEP) Alumni Surveys (2023)	Form and Instruction	Unchanged	Available
Form 0920-1163 Science Ambassador Fellowship (SAF) Alumni Survey	Form and Instruction	Unchanged	Available
0920-1163 EO CR Memo_04182025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-25	Available
0920-1163 EO CR Memo_04182025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-25	Repair queued
Justification_11082024.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-11-13	Available
Justification_11082024.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-11-13	Repair queued
Research Determination Memorandum_ CDC Fellowship Programs Assessments.pdf	Supplementary Document	Uploaded 2022-11-22	Available
Research Determination Memorandum_ CDC Fellowship Programs Assessments.pdf	Supplementary Document	Uploaded 2022-11-22	Repair queued
Att 6 - Public Comment.pdf	Supplementary Document	Uploaded 2022-11-22	Available
Att 6 - Public Comment.pdf	Supplementary Document	Uploaded 2022-11-22	Repair queued
Att 4 - Published 60-Day FRN.pdf	Supplementary Document	Uploaded 2022-11-22	Available
Att 4 - Published 60-Day FRN.pdf	Supplementary Document	Uploaded 2022-11-22	Repair queued
0920-1163_SSB EO CR_cl.docx	Supporting Statement B	Uploaded 2025-04-25	Available
0920-1163_SSB EO CR_cl.docx	Supporting Statement B	Uploaded 2025-04-25	Repair queued
0920-1163_SSA EO CR_cl.docx	Supporting Statement A	Uploaded 2025-04-25	Available
0920-1163_SSA EO CR_cl.docx	Supporting Statement A	Uploaded 2025-04-25	Repair queued
Att 5 - SORN 09-20-0161.pdf	Supplementary Document	Uploaded 2020-01-28	Available
Att 5 - SORN 09-20-0161.pdf	Supplementary Document	Uploaded 2020-01-28	Repair queued
Att3b-GenIC Request Template 2024_clean.docx	Supplementary Document	Uploaded 2024-11-13	Available
Att3b-GenIC Request Template 2024_clean.docx	Supplementary Document	Uploaded 2024-11-13	Repair queued
Att 2 - List of Fellowships.docx	Supplementary Document	Uploaded 2020-01-28	Available
Att 2 - List of Fellowships.docx	Supplementary Document	Uploaded 2020-01-28	Available
Att 1 - Authorizing Legislation.pdf	Supplementary Document	Uploaded 2020-01-28	Available
Att 1 - Authorizing Legislation.pdf	Supplementary Document	Uploaded 2020-01-28	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
277461	[PHIC] 2025 PHAP Program Separation Survey	Form and Instruction	New	PHAP Program Separation Survey
277359	[PHIC] 2025 PHAP Host Site Supervisor Survey (NGO)	Form	New	PHAP HHS NGO
277352	[PHIC] 2025 PHAP Host Site Supervisor Survey (STLT)	Form and Instruction	New	PHAP Host Site Supervisor Survey
276652	[PHIC] 2025 eFMS Applicant Survey	Form	New	EIS Survey
276652	[PHIC] 2025 eFMS Applicant Survey	Form	New	LLS Survey
275623	[PHIC] 2025 EIS Supervisor and Ext Survey	Form	New	2025 EIS Sup Ex Surv
275623	[PHIC] 2025 EIS Supervisor and Ext Survey	Form	New	2025 EIS Sup Surv
275292	[PHIC] 2025 CDC Science Ambassador Fellowship (SAF) Exit Survey	Form and Instruction	New	2025 SAF Exit Survey
274473	[PHIC] 2025 LLS Host Site Survey	Form	Unchanged	Att_5_2025 LLS Sup ExSurv
274473	[PHIC] 2025 LLS Host Site Survey	Form	Unchanged	Att_1_2025 LLS Sup Surv
274473	[PHIC] 2025 LLS Host Site Survey	Form	Unchanged
273939	[PHIC] 2025 EEP Supervisor Survey	Form and Instruction	Unchanged	2025 EEP Supervisor Evaluation of Student and Program Survey
273939	[PHIC] 2025 EEP Supervisor Survey	Form and Instruction	Unchanged
269124	[PHIC] 2024 CDC Science Ambassador Fellowship Summer Course Survey	Form and Instruction	Unchanged	2024 CDC SAF Summer Course Survey
269124	[PHIC] 2024 CDC Science Ambassador Fellowship Summer Course Survey	Form and Instruction	Unchanged
268339	[PHIC] LLS supervisor surveys	Form	Unchanged	2024 LLS Supervisor Exit Survey
268339	[PHIC] LLS supervisor surveys	Form	Unchanged	LLS Supervisor Survey
268339	[PHIC] LLS supervisor surveys	Form	Unchanged
268338	[PHIC] EIS supervisor surveys	Form	Unchanged	2024 EIS Supervisor Exit Survey
268338	[PHIC] EIS supervisor surveys	Form	Unchanged	2024 EIS Supervisor Survey
268338	[PHIC] EIS supervisor surveys	Form	Unchanged
268316	[PHIC] SAF Exit Survey and Focus Groups	Instruction	Unchanged
268316	[PHIC] SAF Exit Survey and Focus Groups	Form and Instruction	Unchanged	2024 CDC SAF Focus Group Availability
268316	[PHIC] SAF Exit Survey and Focus Groups	Form and Instruction	Unchanged	2024 CDC Science Ambassador Fellowship Exit Survey
268316	[PHIC] SAF Exit Survey and Focus Groups	Form and Instruction	Unchanged
263620	[PHIC] Science Ambassador Fellowship (SAF) Alumni Survey (2023)	Form and Instruction	Unchanged	Science Ambassador Fellowship (SAF) Alumni Survey
263620	[PHIC] Science Ambassador Fellowship (SAF) Alumni Survey (2023)	Form and Instruction	Unchanged
263499	[PHIC] EIS LLS alumni survey 2023	Other-Screenshots	Unchanged
263499	[PHIC] EIS LLS alumni survey 2023	Form and Instruction	Unchanged	[Epidemic Intelligence Service/Laboratory Leadership Service] Alumni Survey
263499	[PHIC] EIS LLS alumni survey 2023	Form and Instruction	Unchanged
263379	[PHIC] Epidemiology Elective Program (EEP) Alumni Surveys (2023)	Other-Screenshot	Unchanged
263379	[PHIC] Epidemiology Elective Program (EEP) Alumni Surveys (2023)	Form and Instruction	Unchanged	EEP Alumni Survey
263379	[PHIC] Epidemiology Elective Program (EEP) Alumni Surveys (2023)	Form and Instruction	Unchanged
263321	Science Ambassador Fellowship (SAF) Alumni Survey (2023)	Form and Instruction	Unchanged	Science Ambassador Fellowship (SAF) Alumni Survey
263321	Science Ambassador Fellowship (SAF) Alumni Survey (2023)	Other-WORD	Unchanged

ICR Details

OMB Control No: 0920-1163	ICR Reference No: 202504-0920-025
Status: Historical Active	Previous ICR Reference No: 202411-0920-004
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-25-0103
Title: [PHIC] Data Collection for CDC Fellowship Programs
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/09/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/01/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2026	02/28/2026	02/28/2026
Responses	9,273	0	9,273
Time Burden (Hours)	4,638	0	4,638
Cost Burden (Dollars)	171,645	0	171,645

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Abstract: The intended use of data collected is to inform the planning, implementation, and continuous quality improvement of CDC Fellowship Programs. Data collection methods include focus groups, interviews, and surveys, using both purposive and probabilistic samples. Respondent populations include potential applicants, fellows, alumni, supervisors, mentors, and employers of alumni. Data will be analyzed relative to the data collection methods and purpose. The Change Request contains minor changes and adheres to recent executive orders.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: U.S. Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 51427	08/22/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 70827	11/21/2022
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 16

table that charts list of burden

IC Title	Form No.	Form Name
Science Ambassador Fellowship (SAF) Alumni Survey (2023)	0920-1163	Science Ambassador Fellowship (SAF) Alumni Survey
[PHIC] 2024 CDC Science Ambassador Fellowship Summer Course Survey	n/a	2024 CDC SAF Summer Course Survey
[PHIC] 2025 CDC Science Ambassador Fellowship (SAF) Exit Survey	n/a	2025 SAF Exit Survey
[PHIC] 2025 EEP Supervisor Survey	0920-1163	2025 EEP Supervisor Evaluation of Student and Program Survey
[PHIC] 2025 EIS Supervisor and Ext Survey	0920-25-0007, 0920-25-0007	2025 EIS Sup Surv ,   2025 EIS Sup Ex Surv
[PHIC] 2025 LLS Host Site Survey	0920-25-0006, 0920-25-0006	Att_1_2025 LLS Sup Surv ,   Att_5_2025 LLS Sup ExSurv
[PHIC] 2025 PHAP Host Site Supervisor Survey (NGO)	0920-25-0163	PHAP HHS NGO
[PHIC] 2025 PHAP Host Site Supervisor Survey (STLT)	n/a	PHAP Host Site Supervisor Survey
[PHIC] 2025 PHAP Program Separation Survey	0920-1163	PHAP Program Separation Survey
[PHIC] 2025 eFMS Applicant Survey	0920-25-0146, 0920-25-0146	LLS Survey ,   EIS Survey
[PHIC] EIS LLS alumni survey 2023	0920-1163	[Epidemic Intelligence Service/Laboratory Leadership Service] Alumni Survey
[PHIC] EIS supervisor surveys	0920-24GH, 0920-24GH	2024 EIS Supervisor Survey ,   2024 EIS Supervisor Exit Survey
[PHIC] Epidemiology Elective Program (EEP) Alumni Surveys (2023)	n/a	EEP Alumni Survey
[PHIC] LLS supervisor surveys	0920-24GG, 0920-24GG	LLS Supervisor Survey ,   2024 LLS Supervisor Exit Survey
[PHIC] SAF Exit Survey and Focus Groups	0920-1163, 0920-1163	2024 CDC Science Ambassador Fellowship Exit Survey ,   2024 CDC SAF Focus Group Availability
[PHIC] Science Ambassador Fellowship (SAF) Alumni Survey (2023)	0920-1163	Science Ambassador Fellowship (SAF) Alumni Survey

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	9,273	9,273	0	0	0	0
Annual Time Burden (Hours)	4,638	4,638	0	0	0	0
Annual Cost Burden (Dollars)	171,645	171,645	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Decrease in Burden Hours is due to a reduction in expected number of GenIC submissions annually based on usage rates over the most recent approval period.

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Annual Cost to Federal Government: $77,441

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/01/2025

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