Information Collection

CDC TRAIN Delayed Follow-up Evaluation Tool

IC 250802 under ICR 202508-0920-005 · OMB 0920-0017.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CDC TRAIN Delayed Follow-up Evaluation Tool	Form and Instruction
CDC TRAIN Follow-Up Evaluation Tool CDC TRAIN Delayed Follow-up Evaluation Tool	Form and Instruction
CDC TRAIN Follow-Up Evaluation Tool Att5_CDCTRAIN_FollowUpEval.docx	Form and Instruction
CDC TRAIN Follow-Up Evaluation Tool Att5_CDCTRAIN_FollowUpEval.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

0920-0017

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 and Instruction	n/a				Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

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

FR Citation: 51 FR 42449

Number of Respondents: 20,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	40,000	-50,000	90,000
Annual IC Time Burden (Hours)	2,000	-1,000	3,000
Annual IC Cost Burden (Dollars)	0	-146,160	146,160

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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