Program Evaluation of CDC’s Core State Injury Prevention Program

OMB 0920-1365

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-21GB Special Emphasis Reports Form and Instruction
Form 0920-1365 Hospital Discharge Injury Indicators Form
Form 0920-1365 Emergency Department Injury Indicators Form
Form 0920-1365 Injury Indicators Form
Form 0920-1365 Recipient-level Group Interviews Form
Form 0920-1365 Economic Indicators Form
Form 0920-1365 Implementation Capacity Rubric Form
Att L_PartnerPortalScreenShots.docx Supplementary Document
Att D_PIA_Core SIPP.pdf Supplementary Document
Att C_ Research Determination.docx Supplementary Document
Att A_Authorizing_Legislation.docx Supplementary Document
Attachment L_Partnes Portal Screen Shoots.pptx Supplementary Document
Attachment D_Privacy Act Applicability CORE SIPP.pdf Supplementary Document
Attachment C_Research STARSDetermination10.25.21.pdf Supplementary Document
Attachment B_60 Dy FRN CoreSIPP_Evaluation.pdf Supplementary Document
Attachment A_Authorizing_Legislation.docx Supplementary Document
0920-1365_SSB_CoreSIPP_Final.docx Supporting Statement B
0920-1365_SSA_CoreSIPP Final.docx Supporting Statement A
Special Emphasis Reports Form and Instruction
Hospital Discharge Injury Indicators Form
Emergency Department Injury Indicators Form
Injury Indicators Form
Recipient-level Group Interviews Form
Economic Indicators Form
Implementation Capacity Rubric Form