NCHHSTP] NPIN Initial Questionnaire Telephone Script for New Organizations

[NCHHSTP] Resources and Services Database of the National Prevention Information Network

Documents and Forms

Document Name Document Type
Form 0920-0255 NCHHSTP] NPIN Initial Questionnaire Telephone Script for New Organizations Form and Instruction
0920-0255 NPIN Initial Questionnaire Telephone Script Att 3A_NPIN Initial Questionnaire Phone Script _OMB0920-0255.docx Form and Instruction
0920-0255 NPIN Initial Questionnaire Telephone Script Att 3A_NPIN Initial Questionnaire Phone Script _OMB0920-0255.docx Form and Instruction
0920-0255 NPIN Questionnaire for New Organizations-Doxy PEP_Free m Att 3A_NPIN Questionnaire for New Organizations_Free Mpox Vaccine_Doxy PEP.docx Form and Instruction
0920-0255 NPIN Questionnaire for New Organizations-Doxy PEP_Free m Att 3A_NPIN Questionnaire for New Organizations_Free Mpox Vaccine_Doxy PEP.docx Form and Instruction

Information Collection (IC) Details

IC Title:	NCHHSTP] NPIN Initial Questionnaire Telephone Script for New Organizations	Agency IC Tracking Number:	0920-0255

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 and Instruction	0920-0255	NPIN Initial Questionnaire Telephone Script	Att 3A_NPIN Initial Questionnaire Phone Script _OMB0920-0255.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-0255	NPIN Questionnaire for New Organizations-Doxy PEP_Free mpox vaccine	Att 3A_NPIN Questionnaire for New Organizations_Free Mpox Vaccine_Doxy PEP.docx	N/A	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	140	140
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.