Objectives 1 and 2 ACASI Questionaire

Incident HIV/ Hepatitis B virus infections in South African blood donors:Behavioral risk factors, genotypes and biological characterization of early infection (NHLBI)

Documents and Forms

Document Name Document Type
Form 1 Objectives 1 and 2 ACASI Questionaire Form and Instruction
1 ACASI Questionaire Attachment 2A HIV_HBV_Objectives_1_2_ACASI_Q_12_2013_V_1.0.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Objectives 1 and 2 ACASI Questionaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 and Instruction	1	ACASI Questionaire	Attachment 2A HIV_HBV_Objectives_1_2_ACASI_Q_12_2013_V_1.0.docx		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 483	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	483	483
Annual IC Time Burden (Hours)	274	274
Annual IC Cost Burden (Dollars)	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.