2016 National Ryan White Conference on HIV Care and Treatment Conference Evaluation

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Document Name Document Type
Form 1 2016 National Ryan White Conference on HIV Care and Treatment Conference Evaluation Form and Instruction
Example modified session evaluation 2016-07-06.pdf Other-Example
1 Overall 2016 RW Conference Meeting Evaluation Overall 2016 RW Conference Meeting Evaluation_OAA_clean_UPDATED.docx Form and Instruction
Supporting Statement NRWC 2016.docx Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	2016 National Ryan White Conference on HIV Care and Treatment Conference Evaluation	Agency IC Tracking Number:

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	Overall 2016 RW Conference Meeting Evaluation	Overall 2016 RW Conference Meeting Evaluation_OAA_clean_UPDATED.docx		Yes	Yes	Fillable Fileable
Other-Example			Example modified session evaluation 2016-07-06.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,069	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,069	2,069
Annual IC Time Burden (Hours)	1,490	1,490
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	Supporting Statement NRWC 2016.docx	07/18/2016

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