Information Collection Request

National HIV Behavioral Surveillance System

ICR 201609-0920-008 · OMB 0920-0770 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
NHBS Behavioral Assessment Survey (HET) Form and Instruction Modified Available
NHBS Behavioral Assessment (IDU) Form and Instruction Modified Repair queued
NHBS Recruiter Debriefing Form and Instruction Modified Available
NHBS Behavioral Assessment (MSM) Form and Instruction Modified Repair queued
NHBS Screening (All Respondent Groups) Form and Instruction Modified Available
Att 18_Auth to Operate for DCC.pdf Supplementary Document Uploaded 2016-12-08 Available
Att 17_References.docx Supplementary Document Uploaded 2016-12-08 Available
Att 16_Response rate calculations.docx Supplementary Document Uploaded 2016-12-08 Available
Att 14_Model recruitment coupon.docx Supplementary Document Uploaded 2016-12-08 Available
Att 13_Summary of Changes to Data Collection_11 29 16.docx Supplementary Document Uploaded 2016-12-08 Available
Att 12_Sample analysis tables.pdf Supplementary Document Uploaded 2016-12-08 Available
Att 11_CDC IRB determination.pdf Supplementary Document Uploaded 2016-12-08 Available
Att 10_Model Consent Form.doc Supplementary Document Uploaded 2016-12-08 Available
Att 9_Consultants.pdf Supplementary Document Uploaded 2016-12-08 Available
Att 8_NHBS cycle overview.pdf Supplementary Document Uploaded 2016-12-08 Available
Att 7_Agreement to abide by restrictions.docx Supplementary Document Uploaded 2016-12-08 Available
Att 6_Assurance of Confidentiality.pdf Supplementary Document Uploaded 2016-12-08 Available
Att 5_NHBS Publications.doc Supplementary Document Uploaded 2016-12-08 Repair queued
Att 2a Public Comment.docx Supplementary Document Uploaded 2016-12-08 Available
Att 2_60 Day_FRN.pdf Supplementary Document Uploaded 2016-12-08 Available
Att 1_PHSA.pdf Supplementary Document Uploaded 2016-12-08 Available
Supporting Statement B_03 14 17.docx Supporting Statement B Uploaded 2017-03-15 Available
Supporting Statement A_03 14 17.docx Supporting Statement A Uploaded 2017-03-15 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
196958 NHBS Behavioral Assessment Survey (HET) Form and Instruction Modified
196957 NHBS Behavioral Assessment (IDU) Form and Instruction Modified
196956 NHBS Recruiter Debriefing Form and Instruction Modified
182203 NHBS Behavioral Assessment (MSM) Form and Instruction Modified
182201 NHBS Screening (All Respondent Groups) Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2020 36 Months From Approved 05/31/2017
29,136 0 31,668
9,138 0 9,932
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 29,136 31,668 0 -2,532 0 0
Annual Time Burden (Hours) 9,138 9,932 0 -794 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No