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NPIN Online Questionnaire for New Organizations
[NCHHSTP] Resources and Services Database of the National Prevention Information Network
OMB: 0920-0255
IC ID: 223253
OMB.report
HHS/CDC
OMB 0920-0255
ICR 202603-0920-007
IC 223253
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NPIN Online Questionnaire for New Organizations
Agency IC Tracking Number:
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
None
NPIN Online Questionnaire
Att 4_NPIN Online Questionnaire_with Mpox Vaccine and Mpox Testing.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0255
NPIN Online Questionnaire-Doxy PEP_Free mpox vaccine
Att 4‑ScreenShots_NPIN Online Questionnaire_Free mpox vaccine and Doxy PEP.docx
N/A
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0255
NPIN Online Questionnaire_MAR2026
Att 4_ NPIN Online Questionnaire_clean.docx
N/A
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,965
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 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,965
0
360
0
0
1,605
Annual IC Time Burden (Hours)
197
0
36
0
0
161
Annual IC Cost Burden (Dollars)
0
0
0
0
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.
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