Public Health Associate Program (PHAP) Alumni Assessment

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1078 can be found here:

Documents and Forms

Document Name Document Type
Public Health Associate Program (PHAP) Alumni Assessment Form and Instruction
Public Health Associate Program (PHAP) Alumni Assessment Att C PHAP Alumni Assessment_Web Version.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Public Health Associate Program (PHAP) Alumni Assessment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	Public Health Associate Program (PHAP) Alumni Assessment	Att C PHAP Alumni Assessment_Web Version.docx	None	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: 09-20-0161 - Records of Health Professionals in Disease Prevention and Control Training Programs	FR Citation: 51 FR 42485

Number of Respondents: 160	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	160	160
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.