NPCR - Program Evaluation Instrument (NPCR-PEI) (Online)

National Program of Cancer Registries Program Evaluation Instrument

Documents and Forms

Document Name Document Type
Form CDC.0920-0706 NPCR - Program Evaluation Instrument (NPCR-PEI) (Online) Form
CDC.0920-0706 NPCR Program Evaluation Instrument (Online) 0920-0706 Attachment 3B_ NPCR PEI Survey -Web Version_ FinalRevision_08102021.pdf Form
CDC.0920-0706 NPCR Program Evaluation Instrument (Online) 0920-0706 Attachment 3B_ NPCR PEI Survey -Web Version_ FinalRevision_08102021.pdf Form

Information Collection (IC) Details

IC Title:	NPCR - Program Evaluation Instrument (NPCR-PEI) (Online)	Agency IC Tracking Number:	0920-0706

Is this a Common Form? No		IC Status: Modified

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	CDC.0920-0706	NPCR Program Evaluation Instrument (Online)	0920-0706 Attachment 3B_ NPCR PEI Survey -Web Version_ FinalRevision_08102021.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	60	60
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.