Clinic Screener - HIV Positive Screened Individuals

Monitoring Outcomes of the Enhanced Comprehensive HIV Prevention Plan (ECHPP) Project

OMB: 0920-0922

IC ID: 200565

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

View Information Collection (IC)

Clinic Screener - HIV Positive Screened Individuals
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Rev Attach 3c Eligibility Screener-Clinic Survey.docx Yes Yes Printable Only

Health Immunization Management

 

1,400 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Requested 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 1,400 0 0 0 0 1,400
Annual IC Time Burden (Hours) 117 0 0 0 0 117
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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