HIV/AID Rapid Testing Clinical Information Form

Rapid HIV Testing Clinical Information Form for Minority AIDS Initiative (MAI) for Ethnic Racial Minorities at Risk for Substance Use and HIV/AIDS

OMB: 0930-0295

IC ID: 185896

Documents and Forms
Information Collection (IC) Details

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HIV/AID Rapid Testing Clinical Information Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form Information Form RHTI Data Collection Tool 5-29-11-41am.doc No No Paper Only

Health Public Health Monitoring

 

20,000 80
   
State, Local, and Tribal Governments
 
   0 %

  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 20,000 0 20,000 0 0 0
Annual IC Time Burden (Hours) 3,192 0 3,192 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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