Information Collection Request

Adult and Pediatric HIV/AIDS Confidential Case Reports for National HIV/AIDS Surveillance

ICR 200611-0920-001 · OMB 0920-0573 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CDC 50.42A Att C_Adult HIV/AIDS Confidential Case Report Form Modified Available
Form None assigned Enhanced HIV/AIDS Surveillance to Maximally Reduce Perinatal HIV Transmission Form and Instruction New Available
Form CDC 50.42A Adult HIV/AIDS Confidential Case Report Form New Available
Form CDC 50.42A Adult HIV/AIDS Confidential Case Report Form New Available
Form CDC 50.42B Pediatric HIV/AIDS Confidential Case Report Form New Available
Form CDC 50.42A Adult HIV/AIDS Confidential Case Report Form New Available
Form CDC 50.42B Pediatric HIV/AIDS Confidential Case Report Form New Available
Form CDC 50.42B Pediatric HIV/AIDS Confidential Case Report Form New Available
Form CDC 50.42A Att C_Adult HIV/AIDS Confidential Case Report Form New Available
Attachment E CRF instructions.pdf Supplementary Document Uploaded 2006-11-15 Available
0920-0573 30-Day FRN published.htm Supplementary Document Uploaded 2006-11-15 Available
Attachment M statistical consultation summary.pdf Supplementary Document Uploaded 2006-11-14 Available
Attachment L Assurance.pdf Supplementary Document Uploaded 2006-11-14 Available
Attachment J Surv Coord and Consultants.pdf Supplementary Document Uploaded 2006-11-14 Available
Attachment I HASR.pdf Supplementary Document Uploaded 2006-11-14 Available
Attachment K Seccon.pdf Supplementary Document Uploaded 2006-11-14 Available
Attachment B.pdf Supplementary Document Uploaded 2006-11-14 Available
Attachment A Public Health Laws 42 USC 242b 242 k and 242m.pdf Supplementary Document Uploaded 2006-11-14 Available
0920-0573 - Abstract for Part I.doc Supplementary Document Uploaded 2006-11-14 Available
0920-0573 Supporting Statement final 111306.doc Supporting Statement A Uploaded 2007-02-02 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
7028 0920-0573 - Adult Case Report: AIDS Form ModifiedAtt C_Adult HIV/AIDS Confidential Case Report
46035 0920-0573 - Enhance Perinatal Surveillance (EPS) Data Collection Form and Instruction NewEnhanced HIV/AIDS Surveillance to Maximally Reduce Perinatal HIV Transmission
46034 0920-0573 - VARHS -variant, atypical, and resistant HIV Surveillance Data Elements Instruction New
46034 0920-0573 - VARHS -variant, atypical, and resistant HIV Surveillance Data Elements Form NewAdult HIV/AIDS Confidential Case Report
46033 0920-0573 - HIV Incidence Surveillance Data Elements and Procedures Form NewAdult HIV/AIDS Confidential Case Report
46033 0920-0573 - HIV Incidence Surveillance Data Elements and Procedures Instruction New
46032 0920-0573 - Case Report Updates Form NewPediatric HIV/AIDS Confidential Case Report
46032 0920-0573 - Case Report Updates Form NewAdult HIV/AIDS Confidential Case Report
46031 0920-0573 - Pediatric Case Report: HIV Form NewPediatric HIV/AIDS Confidential Case Report
46030 0920-0573 - Pediatric Case Report: AIDS Form NewPediatric HIV/AIDS Confidential Case Report
46029 0920-0573 - Adult Case Report: HIV Form NewAtt C_Adult HIV/AIDS Confidential Case Report

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2010 36 Months From Approved 02/28/2007
271,337 0 79,981
57,774 0 13,191
0 0 0





Reginfo record details
8
table that charts list of burden
IC Title Form No. Form Name
0920-0573 - Adult Case Report: AIDS CDC 50.42A
0920-0573 - Adult Case Report: HIV CDC 50.42A
0920-0573 - Case Report Updates CDC 50.42A, CDC 50.42B ,  
0920-0573 - Enhance Perinatal Surveillance (EPS) Data Collection None assigned
0920-0573 - HIV Incidence Surveillance Data Elements and Procedures CDC 50.42A
0920-0573 - Pediatric Case Report: AIDS CDC 50.42B
0920-0573 - Pediatric Case Report: HIV CDC 50.42B
0920-0573 - VARHS -variant, atypical, and resistant HIV Surveillance Data Elements CDC 50.42A

table that charts list of burden
  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 271,337 79,981 0 191,356 0 0
Annual Time Burden (Hours) 57,774 13,191 0 44,583 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No