HIV-negative MSM Screener-English

Understanding Barriers and Facilitators to HIV Prevention for Men who Have Sex with Men (MSM) - Pulse Study

Documents and Forms

Document Name Document Type
Form 0920-015AGK HIV-negative MSM Screener-English Form and Instruction
0920-015AGK Att 3a HIV-Neg MSM Screener_English Att 3a HIV-Neg MSM Screener_English.docx Form and Instruction

Information Collection (IC) Details

IC Title:	HIV-negative MSM Screener-English	Agency IC Tracking Number:	15AGK

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	0920-015AGK	Att 3a HIV-Neg MSM Screener_English	Att 3a HIV-Neg MSM Screener_English.docx		No		Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 210	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	210	210
Annual IC Time Burden (Hours)	18	18
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.