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Federal forms, ICRs, and supporting documents

Information Collection

Examining the Efficacy of the HIV Testing Social Marketing Campaign for African American Women (HTSMC) - Screening and Baseline Survey

IC 180286 under ICR 200705-0920-008 · OMB 0920-0752.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Examining the Efficacy of the HIV Testing Social Marketing Campaign for African American Women (HTSMC) - Screening and Baseline Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Study Screener Attachment 5.study screener 4-24-2007 w o trkg.doc Yes Yes Fillable Printable
Form and Instruction None Evaluation Data Collection Instrument Attachment 2.datacollectioninstrument 4-24-2007 w o trkg.doc Yes Yes Fillable Printable

Health Illness Prevention

 

1,630 0
   
Individuals or Households
 
   100 %

  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 1,630 0 1,630 0 0 0
Annual IC Time Burden (Hours) 408 0 408 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Consent Forms Attachment 6. consentforms 4-24-2007.doc 05/04/2007
Email Notification and Email and Telephone Reminders Attachment 7.reminders 4-24-2007.doc 05/04/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.