Screeners and Survey Questionnaire

Evaluation of NIAID's HIV Vaccine Research Education Initiative Highly Impacted Population Survey

OMB: 0925-0618

IC ID: 191539

Documents and Forms
Information Collection (IC) Details

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Screeners and Survey Questionnaire
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Survey Attachment C_HIP_Survey_11-18-09.doc Yes Yes Paper Only
Instruction Attachment D_Letter_Scripts_Emails_10_26_09.doc Yes Yes Paper Only

Health Health Care Services

 

3,500 0
   
Individuals or Households
 
   29 %

  Requested 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 3,500 0 3,500 0 0 0
Annual IC Time Burden (Hours) 1,167 0 1,167 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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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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