HIV Rapid Testing Performance Evaluation Sample and Laboratory Practices Questionnaire Surveys - HIV Rapid Testing Form EZ

Performance Evaluation Program for Rapid HIV Testing

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0595 can be found here:

Documents and Forms

Document Name Document Type
Form none assigned HIV Rapid Testing Performance Evaluation Sample and Laboratory Practices Questionnaire Surveys - HIV Rapid Testing Form EZ Form
none assigned HIV Rapid Testing Results Booklet Attachment #3- p0606dcf OMB.doc Form

Information Collection (IC) Details

IC Title:	HIV Rapid Testing Performance Evaluation Sample and Laboratory Practices Questionnaire Surveys - HIV Rapid Testing Form EZ	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
Form	none assigned	HIV Rapid Testing Results Booklet	Attachment #3- p0606dcf OMB.doc		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 750	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 15 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	250	250
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.