College and University Survey

Sexually Transmitted Infection Services at US Colleges and Universities

Documents and Forms

Document Name Document Type
College and University Survey Form
Survey of Colleges and Universities Att3a CollegeSurveyScreenShots.docx Form
Att3 College Survey.docx Survey - Word IC Document

Information Collection (IC) Details

IC Title:	College and University Survey	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	none	Survey of Colleges and Universities	Att3a CollegeSurveyScreenShots.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 885	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	885	885
Annual IC Time Burden (Hours)	664	664
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Survey - Word	Att3 College Survey.docx	04/09/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.