OMB control number
Indian Affairs Public Health Needs Assessment
OMB 1076-0200 · DOI/BIA.
Enhancing the public health and safety capacity throughout Indian Affairs is a force multiplier in achieving the goals of our agency and in meeting the Occupational Safety and Health Act of 1970, Section 5 directive to create a place of employment free from recognized hazards. The purpose of this survey is to identify and prioritize public health issues and needs and enhance the public health and safety capacity throughout Indian country. The Office of Facilities, Property and Safety Management (OFPSM) Public Health and Safety (PHS) Team will use survey results to develop and coordinate action plans.
The latest form for Indian Affairs Public Health Needs Assessment expires 2026-04-30 and can be found here.
Document Name |
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Form and Instruction |
Form and Instruction |
Supplementary Document |
Supplementary Document |
Supporting Statement B |
Supporting Statement A |
Supplementary Document |
Supplementary Document |
Survey (Individuals)
IAFR001470__SSB_Public Health Needs Assessment.docx
Survey (Individuals) | Extension without change of a currently approved collection | 2025-09-23 | ||
|
Approved without change |
New collection (Request for a new OMB Control Number) | 2023-01-11 |
Survey (State, Local, Tribal Governments)
Federal Enterprise Architecture: Health - Public Health Monitoring
| Form N/A | Indian Affairs Public Health Needs Assessment Survey | Fillable Fileable | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.