OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

[NCHHSTP] The STD Surveillance Network (SSuN)

OMB 0920-1072 ยท HHS/CDC.

OMB 0920-1072

The STD Surveillance Network provides critical clinical, demographic and behavioral information through enhanced and sentinel surveillance among people diagnosed with gonorrhea, syphilis and those persons seeking care at STD clinics in order to enhance STD surveillance data, to inform a more comprehensive understanding of epidemiologic trends and determinants of STDs of interest, monitor public health program impact and provide a more robust evidence base for directing public health action. This change request is to adhere to recent executive orders.

The latest form for [NCHHSTP] The STD Surveillance Network (SSuN) expires 2026-09-30 and is listed under ICR 202503-0920-019.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-1072 SSuN Data ElementsForm and Instruction
Form 0920-1072 Data Cleaning/Validation/Transmissions (Strategy B)Form and Instruction
Form 0920-1072 SSuN Data ElementsForm and Instruction
Form 0920-1072 SSuN Gonorrhea and Syphilis Patient Interview & STD Clinic Patient QuestionnaireForm and Instruction
Form 0920-1072 STD Clinics (Waiting Room) SurveyForm and Instruction
Form 0920-1072 SSuN Data ElementsForm and Instruction
Form 0920-1072 Data Cleaning/Validation/Transmission (Strategy A)Form and Instruction
Form 0920-1072 SSuN Data ElementsForm and Instruction
Form 0920-1072 Record Abstraction (STD Clinics)Form and Instruction
Form 0920-1072 SSuN Data ElementsForm and Instruction
Form 0920-1072 SSuN Gonorrhea and Syphilis Patient Interview & STD Clinic Patient QuestionnaireForm and Instruction
Form 0920-1072 SSuN Gonorrhea & Syphilis Patient Interview (Random Sampling)Form and Instruction
Change Request Memo.docxJustification for No Material/Nonsubstantive Change
Change Request Memo.docx Justification for No Material/Nonsubstantive Change
Att11_PIA_0920-1072.pdfSupplementary Document
Att 10_TableofSensitiveQuestions_Clean.docxSupplementary Document
Att9_SSuNDeterminationofNonResearch_0920-1073_Rev2023.pdfSupplementary Document
Att7_SSuN_Publications_0960-1072_Rev2023.pdfSupplementary Document
Att7_SSuN_Publications_0960-1072_Rev2023.pdf Supplementary Document
Att6_Collaborators_0920-1072_Rev2023.docxSupplementary Document
Att6_Collaborators_0920-1072_Rev2023.docx Supplementary Document
Att 4_Protocol_Clean.docxSupplementary Document
Att 4_Protocol_Clean.docx Supplementary Document
Att3_30Day_SummaryofChanges_0920-1072_Revision2023.docxSupplementary Document
Att2b_60_Day_FRN_Comments.docxSupplementary Document
Att2b_60_Day_FRN_Comments.docx Supplementary Document
Att2a_60_Day_FRN_Pub_3-10-2023.pdfSupplementary Document
Att2a_60_Day_FRN_Pub_3-10-2023.pdf Supplementary Document
Att1_Auth_Legislation_0920-1072_Rev2023.docxSupplementary Document
Att1_Auth_Legislation_0920-1072_Rev2023.docx Supplementary Document
SSB_Clean.docxSupporting Statement B
SSB_Clean.docxSupporting Statement B
SSA_Clean.docxSupporting Statement A
SSA_Clean.docxSupporting Statement A
Data Cleaning/Validation/Transmissions (Strategy B) Form and Instruction
Data Cleaning/Validation/Transmissions (Strategy B) Form and Instruction
STD Clinics (Waiting Room) Survey Form and Instruction
STD Clinics (Waiting Room) Survey Form and Instruction
STD Clinics (Waiting Room) Survey Form and Instruction
Data Cleaning/Validation/Transmission (Strategy A) Form and Instruction
Data Cleaning/Validation/Transmission (Strategy A) Form and Instruction
Record Abstraction (STD Clinics) Form and Instruction
Record Abstraction (STD Clinics) Form and Instruction
SSuN Gonorrhea & Syphilis Patient Interview (Random Sampling) Form and Instruction
SSuN Gonorrhea & Syphilis Patient Interview (Random Sampling) Form and Instruction
SSuN Gonorrhea & Syphilis Patient Interview (Random Sampling) Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202503-0920-019 No material or nonsubstantive change to a currently approved collection 2025-05-28
202306-0920-010 Revision of a currently approved collection 2023-08-01 Approved without change
202004-0920-024 Revision of a currently approved collection 2020-04-30 Approved without change
201807-0920-010 Reinstatement with change of a previously approved collection 2018-08-08 Approved without change
201412-0920-010 New collection (Request for a new OMB Control Number) 2014-12-23 Approved with change

OMB Details

SSuN Gonorrhea & Syphilis Patient Interview (Random Sampling)

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form 0920-1072SSuN Gonorrhea and Syphilis Patient Interview & STD Clinic Patient QuestionnaireNAForm and instruction
Form 0920-1072SSuN Data ElementsFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.