Health Professional Applicaton for Traiing (HPAT)

Health Professional Application for Training (HPAT)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0995 can be found here:

Documents and Forms

Document Name Document Type
Att 3 HPAT- Paper.docx Other-WORD
Att 4 HPAT screenshots.docx Other-WORD

Information Collection (IC) Details

IC Title:	Health Professional Applicaton for Traiing (HPAT)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Other-WORD			Att 3 HPAT- Paper.docx		Yes	Yes	Fillable Printable
Other-WORD			Att 4 HPAT screenshots.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: 09-20-0161 "Records of Health Professionals in Disease Prevention and Control Training Programs"	FR Citation: 51 FR 42485

Number of Respondents: 7,400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 70 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,400	7,400
Annual IC Time Burden (Hours)	617	617
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.