[NCEH] Poison Center Collaborations for Public Health Emergencies

ICR 202211-0920-012

OMB: 0920-1166

Federal Form Document

Forms and Documents

Document Name	Status
0 - PCCPHE ICR Privacy Act Checklist 20221109.docx Supplementary Document	2022-11-18
1 - List of Attachments PCCPHE_20221109.docx Supplementary Document	2022-11-18
Att15_Agreemnt Prohibit Identifiers.pdf Supplementary Document	2022-11-18
1 - SSB PCCPHE Revision_20221109.docx Supporting Statement B	2022-11-18
1 - SSA PCCPHE Revision_20221109.docx Supporting Statement A	2022-11-18
Att14_Privacy Impact Assessment PCCPHE.pdf Supplementary Document	2022-11-18
Att8_Example Web Questionnaire.pdf Supplementary Document	2022-11-18
Att16_NCEH STARS Determination PCCPHE.pdf Supplementary Document	2022-11-18
Att13_Burden Memo PCCPHE.docx Supplementary Document	2022-11-18
Att7_Example Parent-Child Questionnaire.docx Supplementary Document	2022-11-18
Att6_Example Adolescent Questionnaire.docx Supplementary Document	2022-11-18
Att5_Example Adult Questionnaire.docx Supplementary Document	2022-11-18
Att12_Sample Consent and Assent Forms.docx Supplementary Document	2022-11-18
Att11_GenIC Rqst Apprvl Form PCCPHE.docx Supplementary Document	2022-11-18
Att10_Advanced Notification Email for OMB.docx Supplementary Document	2022-11-18
Att9_Step-by-Step How to Use the Generic Clearance.docx Supplementary Document	2022-11-18
Att4_Data Licensing Agreement.pdf Supplementary Document	2022-11-18
Att3_Poison Center Map.pdf Supplementary Document	2022-11-18
Att2_60D FRN PCCPHE.pdf Supplementary Document	2022-11-18
Att1 Authorizing Legislation.pdf Supplementary Document	2020-02-18
0920-1166 Change Request Justification FY2020 Q1.docx Justification for No Material/Nonsubstantive Change	2020-01-23