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Federal forms, ICRs, and supporting documents

Information Collection

Evaluation of Pharmacy Syringe Access Linked to HIV Testing for Injection Drug Users in New York City (PHarm-HIV) Pharmlink Participant Baseline Survey (Syringe Customer)

IC 190725 under ICR 200909-0920-010 · OMB 0920-0837.

Documents and Forms
Document Name
Document Type
Other-WORD
Information Collection (IC) Details

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Evaluation of Pharmacy Syringe Access Linked to HIV Testing for Injection Drug Users in New York City (PHarm-HIV) Pharmlink Participant Baseline Survey (Syringe Customer)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD 09AF_Att3f_Pharmlink Participant Baseline Survey.doc Yes Yes Fillable Printable

Health Illness Prevention

 

221 0
   
Private Sector Businesses or other for-profits
 
   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 221 0 221 0 0 0
Annual IC Time Burden (Hours) 111 0 111 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.