Information Collection Request

Surveillance of HIV/AIDS Related Events Among Persons Not Receiving Care ("Never In Care")

ICR 200705-0920-010 · OMB 0920-0748 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Qualitative Interview Form and Instruction New Available
Standard Structured Interview Form and Instruction New Available
CDC HIV Response.pdf Supplementary Document Uploaded 2007-07-27 Available
NIC SS Part B 07-05DA 04_11_07.doc Supporting Statement B Uploaded 2007-05-21 Available
Attachment 11 60-day FRN.pdf Supplementary Document Uploaded 2007-05-21 Available
Attachment 10 Sample Size by Project Area.doc Supplementary Document Uploaded 2007-05-21 Available
Attachment 9 Script for Returning Test Results.doc Supplementary Document Uploaded 2007-05-21 Available
Attachment 8 Recruitment Scripts.doc Supplementary Document Uploaded 2007-05-21 Available
Attachment 7 Assurance of Confidentiality.doc Supplementary Document Uploaded 2007-05-21 Available
Attachment 6 Restrictions on Data Release.doc Supplementary Document Uploaded 2007-05-21 Available
Attachment 4 CDC IRB approval.doc Supplementary Document Uploaded 2007-05-21 Available
Attachment 1 a-c Leg Auth.doc Supplementary Document Uploaded 2007-05-21 Available
NIC SS Part A 07-05DA 04_11_07.doc Supporting Statement A Uploaded 2007-05-21 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
180335 Qualitative Interview Form and Instruction New
180334 Standard Structured Interview Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2010 36 Months From Approved
575 0 0
325 0 0
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Standard Structured Interview None Standard Structured Questionnaire for Never In Care Project
Qualitative Interview None Qualitative Interview Guide for Never in Care

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 575 0 0 575 0 0
Annual Time Burden (Hours) 325 0 0 325 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No