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

ICR 202503-0920-007

OMB: 0920-1175

Federal Form Document

Forms and Documents

Document Name	Status
Form 0920-1175 PHA Impact Follow Up - (RedCap form) (New form) Form and Instruction	Unchanged
Form 0920-1175 Performance Measures- Unique Form and Instruction	Unchanged
Form 0920-1175 Standardized Web Statistics - Codebook Form and Instruction	Unchanged
Form 0920-1175 Data Dictionary- State Biomonitoring Data Form and Instruction	Modified
Form 0920-1175 Outreach & Communication Plan Template with Instructions Form and Instruction	Unchanged
Form 0920-1175 Publilc Health Action Report - Existing Awardees Form and Instruction	Unchanged
Form 0920-1175 Environmental Public Health Tracking Work Plan Template Form and Instruction	Unchanged
Form 0920-1175 Metadata Sample Content Form and Instruction	Unchanged
Form 0920-1175 Data Dictionary for Data Submission -- Labs Radon Data Form and Instruction	Unchanged
Form 0920-1175 Data Dictionary- Hospitalizations Form and Instruction	Modified
Form 0920-1175 Data Dictionary - Emergency Department (ED) Visits Form and Instruction	Modified
Form 0920-1175 Data Dictionary – Drinking Water (Community Monitoring) Form and Instruction	Unchanged
Form 0920-1175 Environment Public Health Tracking -- Childhood Blood Lead Poisoning Form and Instruction	Unchanged
Form 0920-1175 Data Dictionary – Birth Defects (Prevelance) Form Form and Instruction	Modified
0920-1175 Change Request Memo - EO14168.docx Justification for No Material/Nonsubstantive Change	2025-03-06
Att6 CDC-RFA-EH17-1702.pdf Supplementary Document	2023-07-06
Att10 Data Management Processes.pdf Supplementary Document	2023-07-06
Att9 NCDM Requirements.pdf Supplementary Document	2023-07-06
Att8 Funding Determination.pdf Supplementary Document	2023-07-06
Att7 Environ PH Trckg 2023 Revision PIA.pdf Supplementary Document	2023-07-06
Att3 NOFO CDC-RFA-EH22-2202.pdf Supplementary Document	2023-07-06
Att2 Environ PH Trckg 60 day FRN publication.pdf Supplementary Document	2023-07-06
Att1_PHSA Section 243&247.docx Supplementary Document	2020-04-27
0 - Environ PH Trckg 2023 Revision SSB.docx Supporting Statement B	2023-07-06
0 - Environ PH Trckg 2023 (REV) SSA.docx Supporting Statement A	2023-07-17

IC Document Collections

IC ID	Document Title	Status
260973	PHA Impact Follow Up - (RedCap form) (New form) Form and Instruction	Unchanged
241554	Performance Measures- Unique Form and Instruction	Unchanged
222657	Standardized Web Statistics - Codebook Form and Instruction	Unchanged
222656	Data Dictionary- State Biomonitoring Data Form and Instruction	Modified
222654	Outreach & Communication Plan Template with Instructions Form and Instruction	Unchanged
222652	Publilc Health Action Report - Existing Awardees Form and Instruction	Unchanged
222650	Environmental Public Health Tracking Work Plan Template Form and Instruction	Unchanged
222649	Metadata Sample Content Form and Instruction	Unchanged
222648	Data Dictionary for Data Submission -- Labs Radon Data Form and Instruction	Unchanged
222646	Data Dictionary- Hospitalizations Form and Instruction	Modified
222533	Data Dictionary - Emergency Department (ED) Visits Form and Instruction	Modified
222532	Data Dictionary – Drinking Water (Community Monitoring) Form and Instruction	Unchanged
222531	Environment Public Health Tracking -- Childhood Blood Lead Poisoning Form and Instruction	Unchanged
222530	Data Dictionary – Birth Defects (Prevelance) Form Form and Instruction	Modified