Information Collection

NNPTC Abbreviated Health Professional Applicaton for Traiing (HPAT)

IC 208451 under ICR 202505-0920-002 · OMB 0920-0995.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-25-0110 NNPTC Abbreviated Health Professional Applicaton for Traiing (HPAT)	Form
Form 0920-25-0110 Att 3_Approved NNPTC HPAT_clean NNPTC Abbreviated Health Professional Applicaton for Traiing (HPAT)	Form
0920-25-0110 Att 3_Approved NNPTC HPAT_clean Att 3_Approved NNPTC HPAT_clean.docx	Form
0920-25-0110 Att 3_Approved NNPTC HPAT_clean Att 3_Approved NNPTC HPAT_clean.docx	Form
Change Request Memo.docx Change Request Memo	IC Document
Change Request Memo.docx Change Request Memo	IC Document

IC Title:

Agency IC Tracking Number:

0920-25-0110

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-25-0110				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: 09-20-0161 "Records of Health Professionals in Disease Prevention and Control Training Programs"

FR Citation: 51 FR 42485

Number of Respondents: 4,500

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	4,500	4,500
Annual IC Time Burden (Hours)	225	225
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Change Request Memo		05/01/2025

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].