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Moderator's Guide
Hemophilia and AIDS/HIV Network for the Dissemination of Information (HANDI) Evaluation Support
OMB: 0920-0858
IC ID: 192851
OMB.report
HHS/CDC
OMB 0920-0858
ICR 201102-0920-004
IC 192851
( )
Documents and Forms
Document Name
Document Type
Moderator's Guide
Form
Moderator's Guide for Parents - phone
ModeratorguideparentsphoneREV_010511.doc
Form
Moderator's Guide for Young Adults - phone
ModeratorguideyoungadultsphoneREV_010510.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Moderator's Guide
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
none
Moderator's Guide for Parents - phone
ModeratorguideparentsphoneREV_010511.doc
No
No
Paper Only
Form
none
Moderator's Guide for Young Adults - phone
ModeratorguideyoungadultsphoneREV_010510.doc
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
Epidemiologic Studies and Surveillance of Disease Problems
FR Citation:
57 FR 62812
Number of Respondents:
108
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
108
0
0
0
0
108
Annual IC Time Burden (Hours)
162
0
0
0
0
162
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.