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Federal forms, ICRs, and supporting documents

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[OPHDST] National Electronic Disease Surveillance System Base System (NBS) Community Satisfaction Assessment

IC 280963 under ICR 202506-0920-002 · OMB 0920-1050.

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

View Information Collection (IC)

[OPHDST] National Electronic Disease Surveillance System Base System (NBS) Community Satisfaction Assessment 0920-26-0216
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a NBS Assessment NBS Assessment.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

411 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 411 0 411 0 0 0
Annual IC Time Burden (Hours) 103 0 103 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
GenIC Request Template 0920-1050 Template NBS Assessment V2-OMB Passback 2 TC KGK_final.docx 06/15/2026
SSA Info Box 0920-1050 SSA NBS Assessment.docx 06/15/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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