Laboratory Practices Questionnaire (LPQ)

Performance Evaluation Program for Rapid HIV Testing

Documents and Forms

Document Name Document Type
Form 4 Laboratory Practices Questionnaire (LPQ) Form and Instruction
4 Laboratory Practices Questionnaire (LPQ) 0920-0595_att4_LPQ Worksheet.doc Form and Instruction
Attachment 4b_LPQRT Cover letter-pswrdltr.doc Attachment 4b_LPQRT Cover letter-pswrdltr IC Document
Attachment 4c_LPQ Report.pdf Attachment 4c_LPQ Report IC Document

Information Collection (IC) Details

IC Title:	Laboratory Practices Questionnaire (LPQ)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	4	Laboratory Practices Questionnaire (LPQ)	0920-0595_att4_LPQ Worksheet.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 330	Number of Respondents for Small Entity: 30

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	330	330
Annual IC Time Burden (Hours)	165	165
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 4b_LPQRT Cover letter-pswrdltr	Attachment 4b_LPQRT Cover letter-pswrdltr.doc	12/18/2009
Attachment 4c_LPQ Report	Attachment 4c_LPQ Report.pdf	12/18/2009

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