Information Collection Request

[NCHHSTP] The STD Surveillance Network (SSuN)

ICR 202609-0920-005 · OMB 0920-1072 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-26-0276 SSuN Data Elements Form and Instruction Modified Available
Form 0920-26-0276 SSuN Data Elements Form and Instruction Modified Available
Form 0920-26-0276 SSuN Gonorrhea and Syphilis Patient Interview & STD Clinic Patient Questionnaire Form and Instruction Modified Available
Form 0920-26-0276 SSuN Data Elements Form and Instruction Modified Available
Form 0920-26-0276 SSuN Data Elements Form and Instruction Modified Available
Form 0920-26-0276 SSuN Data Elements Form and Instruction Modified Available
Form 0920-26-0276 SSuN Gonorrhea and Syphilis Patient Interview & STD Clinic Patient Questionnaire Form and Instruction Modified Available
Att 10_TableOfSensitiveQuestions_Clean.docx Supplementary Document Uploaded 2026-09-22 Available
Att 9_SSuN Project Determination.pdf Supplementary Document Uploaded 2026-09-22 Available
Att 7_Publications.docx Supplementary Document Uploaded 2026-09-22 Available
Att 6_Collaborators_Clean.docx Supplementary Document Uploaded 2026-09-22 Available
Att 4_Protocol.pdf Supplementary Document Uploaded 2026-09-22 Available
Att 3_SummaryofChanges_Clean.docx Supplementary Document Uploaded 2026-09-22 Available
Att 2b_60Day FRN Public Comments.pdf Public Comments Uploaded 2026-09-22 Available
Att 1_Authorizing Legislation.docx Supplementary Document Uploaded 2026-09-22 Available
Change Request Memo.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-05-22 Available
Att11_PIA_0920-1072.pdf Supplementary Document Uploaded 2023-07-18 Available
Att 10_TableofSensitiveQuestions_Clean.docx Supplementary Document Uploaded 2025-05-22 Available
Att9_SSuNDeterminationofNonResearch_0920-1073_Rev2023.pdf Supplementary Document Uploaded 2023-07-18 Available
Att7_SSuN_Publications_0960-1072_Rev2023.pdf Supplementary Document Uploaded 2023-07-18 Available
Att6_Collaborators_0920-1072_Rev2023.docx Supplementary Document Uploaded 2023-07-18 Available
Att 4_Protocol_Clean.docx Supplementary Document Uploaded 2025-05-22 Available
Att3_30Day_SummaryofChanges_0920-1072_Revision2023.docx Supplementary Document Uploaded 2023-07-18 Available
Att2b_60_Day_FRN_Comments.docx Supplementary Document Uploaded 2023-07-18 Available
Att2a_60_Day_FRN_Pub_3-10-2023.pdf Supplementary Document Uploaded 2023-07-18 Available
Att1_Auth_Legislation_0920-1072_Rev2023.docx Supplementary Document Uploaded 2023-07-18 Available
SSB_Clean.docx Supporting Statement B Uploaded 2026-09-22 Available
SSA_Clean.docx Supporting Statement A Uploaded 2026-09-22 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
241635 Data Cleaning/Validation/Transmissions (Strategy B) Form and Instruction ModifiedSSuN Data Elements
241634 STD Clinics (Waiting Room) Survey Form and Instruction ModifiedSSuN Data Elements
241634 STD Clinics (Waiting Room) Survey Form and Instruction ModifiedSSuN Gonorrhea and Syphilis Patient Interview & STD Clinic Patient Questionnaire
232379 Data Cleaning/Validation/Transmission (Strategy A) Form and Instruction ModifiedSSuN Data Elements
232378 Record Abstraction (STD Clinics) Form and Instruction ModifiedSSuN Data Elements
232371 SSuN Gonorrhea & Syphilis Patient Interview (Random Sampling) Form and Instruction ModifiedSSuN Data Elements
232371 SSuN Gonorrhea & Syphilis Patient Interview (Random Sampling) Form and Instruction ModifiedSSuN Gonorrhea and Syphilis Patient Interview & STD Clinic Patient Questionnaire

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 09/30/2026
9,734 8,372
7,237 7,487
0 0





Reginfo record details
5
table that charts list of burden
IC Title Form No. Form Name
Data Cleaning/Validation/Transmission (Strategy A) 0920-26-0276
Data Cleaning/Validation/Transmissions (Strategy B) 0920-26-0276
Record Abstraction (STD Clinics) 0920-26-0276
SSuN Gonorrhea & Syphilis Patient Interview (Random Sampling) 0920-26-0276, 0920-26-0276 ,  
STD Clinics (Waiting Room) Survey 0920-26-0276, 0920-26-0276 ,  

table that charts list of burden
  Total Request 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 9,734 8,372 0 1,362 0 0
Annual Time Burden (Hours) 7,237 7,487 0 -250 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No