NHBS Screening (All Respondent Groups)

National HIV Behavioral Surveillance System

OMB: 0920-0770

IC ID: 182201

Information Collection (IC) Details

View Information Collection (IC)

NHBS Screening (All Respondent Groups)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0770 Attachment 3a 0920-0770_Att 3a_Eligibility Screener_Spanish.pdf Yes Yes Fillable Printable
Form and Instruction 0920-0770 Attachment 2A 0920-0770_Att 2a_Eligibility Screener_Eng.pdf Yes Yes Fillable Printable

Health Public Health Monitoring

 

15,000 0
   
Individuals or Households
 
   100 %

  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 15,000 0 0 0 0 15,000
Annual IC Time Burden (Hours) 1,250 0 0 0 0 1,250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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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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