Information Collection Request

National HIV Behavioral Surveillance System

ICR 201103-0920-003 · OMB 0920-0770 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-0770 NHBS Behavioral Assessment Survey (HET) Form and Instruction New Repair queued
Form 0920-0770 NHBS Behavioral Assessment (IDU) Form and Instruction New Available
Form 0920-0770 NHBS Recruiter Debriefing Form and Instruction New Available
NHBS Survey (HET) Form and Instruction Removed Repair queued
Form 0920-0770 NHBS Behavioral Assessment (MSM) Form and Instruction Modified Repair queued
NHBS Survey (IDU) Form and Instruction Removed Available
Form 0920-0770 NHBS Screening (All Respondent Groups) Form and Instruction Modified Available
0920-0770 Supporting Statement B.doc Supporting Statement B Uploaded 2011-03-08 Available
0920-0770_Att 17_References.pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 16_Response rate calculations.pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 13_Sample analysis tables.pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 12_Summary of Changes to Data Collection Instruments.pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 11_CDC IRB determination (2).pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 10_Model Consent Form.pdf Supplementary Document Uploaded 2011-03-08 Repair queued
0920-0770_Att 9 Consultants.pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 7_NHBS cycle overview.pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 6_Agreement to abide by restrictions.pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 5_Assurance of confidentiality.pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 4_NHBS Publications.pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 1b_Authorization to Operate for DCC.pdf Supplementary Document Uploaded 2011-03-08 Repair queued
0920-0770_Att 1a PHSA.pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 8b_response to FRN comment.pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 15_Recruiter Training Script.pdf Supplementary Document Uploaded 2011-03-08 Available
0920-0770_Att 3b_Behavioral Assessment_MSM_Spanish.pdf Supplementary Document Uploaded 2011-03-04 Available
0920-0770 Supporting Statement A.doc Supporting Statement A Uploaded 2011-03-03 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
196958 NHBS Behavioral Assessment Survey (HET) Form and Instruction New
196957 NHBS Behavioral Assessment (IDU) Form and Instruction New
196956 NHBS Recruiter Debriefing Form and Instruction New
182204 NHBS Survey (HET) Form and Instruction Removed
182203 NHBS Behavioral Assessment (MSM) Form and Instruction Modified
182202 NHBS Survey (IDU) Form and Instruction Removed
182201 NHBS Screening (All Respondent Groups) Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2014 36 Months From Approved 05/31/2011
31,668 0 82,500
9,932 0 29,791
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 31,668 82,500 0 -20,832 -30,000 0
Annual Time Burden (Hours) 9,932 29,791 0 -17,359 -2,500 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No