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HIV Rapid Testing Performance Evaluation Sample and Laboratory Practices Questionnaire Surveys - HIV Rapid Testing Questionnaire
Performance Evaluation Program for Rapid HIV Testing
OMB: 0920-0595
IC ID: 7058
OMB.report
HHS/CDC
OMB 0920-0595
ICR 200612-0920-004
IC 7058
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0595 can be found here:
2010-01-20 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form none assigned
HIV Rapid Testing Performance Evaluation Sample and Laboratory Practices Questionnaire Surveys - HIV Rapid Testing Questionnaire
Form
none assigned HIV Rapid Testing Questionnaire
Attachment #4- Rapid HIV LPQ.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
HIV Rapid Testing Performance Evaluation Sample and Laboratory Practices Questionnaire Surveys - HIV Rapid Testing Questionnaire
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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 Questionnaire
Attachment #4- Rapid HIV LPQ.doc
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
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 New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
750
0
-150
0
0
900
Annual IC Time Burden (Hours)
375
0
200
0
0
175
Annual IC Cost Burden (Dollars)
0
0
0
0
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.