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Federal forms, ICRs, and supporting documents

Information Collection

[OPHDST] Improving Health Data Exchange with Local Health Departments (LHDs)

IC 279752 under ICR 202506-0920-002 · OMB 0920-1050.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
Information Collection (IC) Details

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[OPHDST] Improving Health Data Exchange with Local Health Departments (LHDs) 0920-26-0159
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Webinar Discussion — Large Local Health Department Questions Att B - LHD Listening Sessions.docx Yes Yes Fillable Fileable
Form and Instruction n/a Webinar Discussion — Medium/Small Local Health Department Questions Att C - LHD Listening Sessions.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

50 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 50 0 50 0 0 0
Annual IC Time Burden (Hours) 75 0 75 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Recruitment Email Att A - LHD Listening Sessions.docx 04/02/2026
GenIC Request Template GenIC Template - LHD Listening Sessions_final.docx 04/02/2026
Summary Box SSA - LHD Listening Sessions.docx 04/02/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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