OMB control number

[NCEH] Environmental Public Health Tracking Network (Tracking Network)

OMB 0920-1175 · HHS/CDC.

OMB 0920-1175

CDC's Tracking Program collects, integrates, analyzes, and disseminates data on health, exposure, environmental hazards, and populations in order to drive public health actions that mitigate or prevent the effects of environmental factors on the health of communities. Respondents include 26 funded grantees and unfunded state and local health departments (SLHD). These data are used to describe trends, identify populations at risk, generate hypotheses, and inform public health actions for SLHD. Additional program information collected quarterly or annually are used to evaluate and assess program performance is collected using 6 forms. This change request is to adhere to current executive orders.

The latest form for [NCEH] Environmental Public Health Tracking Network (Tracking Network) expires 2026-08-31 and is listed under ICR 202503-0920-007.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form 0920-1175 PA/PHA Impact Followup	Form and Instruction
Form 0920-1175 PHA Impact Follow Up - (RedCap form) (New form)	Form and Instruction
Form 0920-1175 Performance Measurses - Unique	Form and Instruction
Form 0920-1175 Performance Measures- Unique	Form and Instruction
Form 0920-1175 Standardized Web Statistics - Codebook	Form and Instruction
Form 0920-1175 Standardized Web Statistics - Codebook	Form and Instruction
Form 0920-1175 Data Dictionary- State Biomonitoring Data	Form and Instruction
Form 0920-1175 Data Dictionary- State Biomonitoring Data	Form and Instruction
Form 0920-1175 Outreach & Communication Plan Template with Instructions	Form and Instruction
Form 0920-1175 Outreach & Communication Plan Template with Instructions	Form and Instruction
Form 0920-1175 Program Accomplishments & Public Health Actions	Form and Instruction
Form 0920-1175 Publilc Health Action Report - Existing Awardees	Form and Instruction
Form 0920-1175 Modernizing Environmental Public Health Tracking to Advance Enviromental Health Surveillance Work Plan Template	Form and Instruction
Form 0920-1175 Environmental Public Health Tracking Work Plan Template	Form and Instruction
Form 0920-1175 Metadata Sample Content	Form and Instruction
Form 0920-1175 Metadata Sample Content	Form and Instruction
Form 0920-1175 Radon Testing Form	Form and Instruction
Form 0920-1175 Data Dictionary for Data Submission -- Labs Radon Data	Form and Instruction
Form 0920-1175 Data Dictionary- Hospitalizations	Form and Instruction
Form 0920-1175 Data Dictionary - Emergency Department (ED) Visits	Form and Instruction
Form 0920-1175 Data Dictionary - Emergency Department (ED) Visits	Form and Instruction
Form 0920-1175 Data Dictionary – Drinking Water (Community Monitoring)	Form and Instruction
Form 0920-1175 Data Dictionary – Drinking Water (Community Monitoring)	Form and Instruction
Form 0920-1175 Environmental Public Health Tracking - CHILDHOOD BLOOD LEAD POISONING	Form and Instruction
Form 0920-1175 Environment Public Health Tracking -- Childhood Blood Lead Poisoning	Form and Instruction
Form 0920-1175 Data Dictionary -- Birth Defects(Prevalence)	Form and Instruction
Form 0920-1175 Data Dictionary – Birth Defects (Prevelance) Form	Form and Instruction
0920-1175 Change Request Memo - EO14168.docx	Justification for No Material/Nonsubstantive Change
0920-1175 Change Request Memo - EO14168.docx	Justification for No Material/Nonsubstantive Change
Att6 CDC-RFA-EH17-1702.pdf	Supplementary Document
Att6 CDC-RFA-EH17-1702.pdf	Supplementary Document
Att10 Data Management Processes.pdf	Supplementary Document
Att10 Data Management Processes.pdf	Supplementary Document
Att9 NCDM Requirements.pdf	Supplementary Document
Att9 NCDM Requirements.pdf	Supplementary Document
Att8 Funding Determination.pdf	Supplementary Document
Att8 Funding Determination.pdf	Supplementary Document
Att7 Environ PH Trckg 2023 Revision PIA.pdf	Supplementary Document
Att7 Environ PH Trckg 2023 Revision PIA.pdf	Supplementary Document
Att3 NOFO CDC-RFA-EH22-2202.pdf	Supplementary Document
Att2 Environ PH Trckg 60 day FRN publication.pdf	Supplementary Document
Att2 Environ PH Trckg 60 day FRN publication.pdf	Supplementary Document
Att1_PHSA Section 243&247.docx	Supplementary Document
Att1_PHSA Section 243&247.docx	Supplementary Document
0 - Environ PH Trckg 2023 Revision SSB.docx	Supporting Statement B
0 - Environ PH Trckg 2023 (REV) SSA.docx	Supporting Statement A
0 - Environ PH Trckg 2023 (REV) SSA.docx	Supporting Statement A
PHA Impact Follow Up - (RedCap form) (New form)	Form and Instruction
PHA Impact Follow Up - (RedCap form) (New form)	Form and Instruction
Performance Measures- Unique	Form and Instruction
Performance Measures- Unique	Form and Instruction
Standardized Web Statistics - Codebook	Form and Instruction
Standardized Web Statistics - Codebook	Form and Instruction
Data Dictionary- State Biomonitoring Data	Form and Instruction
Data Dictionary- State Biomonitoring Data	Form and Instruction
Outreach & Communication Plan Template with Instructions	Form and Instruction
Outreach & Communication Plan Template with Instructions	Form and Instruction
Publilc Health Action Report - Existing Awardees	Form and Instruction
Publilc Health Action Report - Existing Awardees	Form and Instruction
Environmental Public Health Tracking Work Plan Template	Form and Instruction
Environmental Public Health Tracking Work Plan Template	Form and Instruction
Metadata Sample Content	Form and Instruction
Metadata Sample Content	Form and Instruction
Data Dictionary for Data Submission -- Labs Radon Data	Form and Instruction
Data Dictionary for Data Submission -- Labs Radon Data	Form and Instruction
Data Dictionary- Hospitalizations	Form and Instruction
Data Dictionary- Hospitalizations	Form and Instruction
Data Dictionary - Emergency Department (ED) Visits	Form and Instruction
Data Dictionary - Emergency Department (ED) Visits	Form and Instruction
Data Dictionary – Drinking Water (Community Monitoring)	Form and Instruction
Data Dictionary – Drinking Water (Community Monitoring)	Form and Instruction
Environment Public Health Tracking -- Childhood Blood Lead Poisoning	Form and Instruction
Environment Public Health Tracking -- Childhood Blood Lead Poisoning	Form and Instruction
Data Dictionary – Birth Defects (Prevelance) Form	Form and Instruction
Data Dictionary – Birth Defects (Prevelance) Form	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202503-0920-007	No material or nonsubstantive change to a currently approved collection	2025-03-28	Approved without change
202306-0920-006	Revision of a currently approved collection	2023-07-18	Approved without change
202004-0920-011	Revision of a currently approved collection	2020-04-27	Approved without change
201902-0920-014	No material or nonsubstantive change to a currently approved collection	2019-02-20	Approved without change
201807-0920-005	No material or nonsubstantive change to a currently approved collection	2018-07-18	Approved without change
201607-0920-005	Existing collection in use without an OMB Control Number	2016-08-02	Approved with change

OMB Details

Data Dictionary – Birth Defects (Prevelance) Form

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
Form	Name	Electronic access	Type
Form 0920-1175	Data Dictionary -- Birth Defects(Prevalence)	Fillable Printable	Form and instruction

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