Emergency Departments Paper and Pencil Questionnaire

Formative Research to Develop Social Marketing Campaigns-Routine HIV Testing For Emergency Medicine Physicians, Prevention Is Care, and Partner Services

OMB: 0920-0775

IC ID: 183189

Information Collection (IC) Details

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Emergency Departments Paper and Pencil Questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Emergency Dept Paper and Pencil Questionnaire A7a Paper and Pencil Survey-Routine Testing.docx No No Paper Only

Health Health Care Services

 

8 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 8 0 -16 0 0 24
Annual IC Time Burden (Hours) 1 0 -3 0 0 4
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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