Provider Survey of Partner Notification

ICR 199804-0920-004

OMB: 0920-0431

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
6846
Migrated
ICR Details
0920-0431 199804-0920-004
Historical Active
HHS/CDC
Provider Survey of Partner Notification
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 06/19/1998
Retrieve Notice of Action (NOA) 04/14/1998
Approval for this collection covers the pilot test only. In addition, the pilot shall vary the respondent payment to equal subsections of the sample using amounts of $0, $15, and $25. The submission of the information collection package for the full study shall include a report from the pilot including a detailed report of the response rates overall and broken down by use of the various response rates. In addition, CDC shall (1) revise the burden statement to conform with requirements of the Paperwork Reduction Act of 1995; (2) revise the questions on race and ethnicity to conform with the revised standards for the classification of date on race and ethnicity -- note that when race and ethnicity are collected separately as they are in this survey, ethnicity shall be collected first; (3) revise question 3 as agreed to with OMB per CDC's revision of 6/19/98. The above changes have been agreed to by CDC.
  Inventory as of this Action Requested Previously Approved
10/31/1998 10/31/1998
240 0 0
120 0 0
0 0 0

This national sample survey of physicians who treat patients with STDs in a wide variety of clinical settings will provide the baseline data necessary to characterize infection control practices, especially partner notification practices, for syphillis, gonorrhea, HIV, and chlamydia and identify the contextual factors that influence those practices. Little is known about physicians' management practices related to STD patients and their partners outside public STD clinics. Without this information, CDC will have little information about STD treatment, reporting, and partner management services provided.

None
None


No

1
IC Title Form No. Form Name
Provider Survey of Partner Notification

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 240 0 0 240 0 0
Annual Time Burden (Hours) 120 0 0 120 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/14/1998


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