Paper and Pencil Questionnaire

Formative Research to Inform an HIV Testing Social Marketing Campaign for African American Men Who Have Sex with Men (MSM)

OMB: 0920-0762

IC ID: 182367

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

View Information Collection (IC)

Paper and Pencil Questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD 0762_Att3b.Paper and Pencil Survey_081709.doc Yes Yes Fillable Printable

Health Illness Prevention

 

144 0
   
Individuals or Households
 
   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 144 0 0 0 0 144
Annual IC Time Burden (Hours) 36 0 0 0 0 36
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.

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