OMB control number

[NCHHSTP] The STD Surveillance Network (SSuN)

OMB 0920-1072 · HHS/CDC.

OMB 0920-1072

The STD Surveillance Network provides critical clinical, demographic and behavioral information through enhanced and sentinel surveillance among people diagnosed with gonorrhea, syphilis and those persons seeking care at STD clinics in order to enhance STD surveillance data, to inform a more comprehensive understanding of epidemiologic trends and determinants of STDs of interest, monitor public health program impact and provide a more robust evidence base for directing public health action. This change request is to adhere to recent executive orders.

The latest form for [NCHHSTP] The STD Surveillance Network (SSuN) expires 2026-09-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-1072 Data Cleaning/Validation/Transmissions (Strategy B) Form and Instruction
Form 0920-1072 STD Clinics (Waiting Room) Survey Form and Instruction
Form 0920-1072 Data Cleaning/Validation/Transmission (Strategy A) Form and Instruction
Form 0920-1072 Record Abstraction (STD Clinics) Form and Instruction
Form 0920-1072 SSuN Gonorrhea & Syphilis Patient Interview (Random Sampling) Form and Instruction
Change Request Memo.docx Justification for No Material/Nonsubstantive Change
Att11_PIA_0920-1072.pdf Supplementary Document
Att 10_TableofSensitiveQuestions_Clean.docx Supplementary Document
Att9_SSuNDeterminationofNonResearch_0920-1073_Rev2023.pdf Supplementary Document
Att7_SSuN_Publications_0960-1072_Rev2023.pdf Supplementary Document
Att6_Collaborators_0920-1072_Rev2023.docx Supplementary Document
Att 4_Protocol_Clean.docx Supplementary Document
Att3_30Day_SummaryofChanges_0920-1072_Revision2023.docx Supplementary Document
Att2b_60_Day_FRN_Comments.docx Supplementary Document
Att2a_60_Day_FRN_Pub_3-10-2023.pdf Supplementary Document
Att1_Auth_Legislation_0920-1072_Rev2023.docx Supplementary Document
SSB_Clean.docx Supporting Statement B
SSA_Clean.docx Supporting Statement A
Data Cleaning/Validation/Transmissions (Strategy B) Form and Instruction
STD Clinics (Waiting Room) Survey Form and Instruction
Data Cleaning/Validation/Transmission (Strategy A) Form and Instruction
Record Abstraction (STD Clinics) Form and Instruction
SSuN Gonorrhea & Syphilis Patient Interview (Random Sampling) Form and Instruction

All Historical Document Collections

202503-0920-019	No material or nonsubstantive change to a currently approved collection	2025-05-28
202306-0920-010 Approved without change	Revision of a currently approved collection	2023-08-01
202004-0920-024 Approved without change	Revision of a currently approved collection	2020-04-30
201807-0920-010 Approved without change	Reinstatement with change of a previously approved collection	2018-08-08
201412-0920-010 Approved with change	New collection (Request for a new OMB Control Number)	2014-12-23

OMB Details

SSuN Gonorrhea & Syphilis Patient Interview (Random Sampling)

Federal Enterprise Architecture: Health - Public Health Monitoring

Form 0920-1072	SSuN Gonorrhea and Syphilis Patient Interview & STD Clinic Patient Questionnaire	NA	Form and instruction
Form 0920-1072	SSuN Data Elements	Fillable Fileable	Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.