Information Collection

Assessing Client Factors Associated with Detectable HIV Viral Loads; and Models of Care the Ryan White HIV/AIDS Program

IC 228991 under ICR 201711-0906-001 · OMB 0906-0033.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment A - Provider Interview Guide - Suppression.docx	Other-Interview
Attachment B - Client Survey.docx	Other-Interview
Attachment C - Client Interview.docx	Other-Interview
Attachment D - Provider Interview Guide - Models of Care.docx	Other-Interview
Attachment E - Client Focus Group Guide.docx	Other-Interview

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Electronic Capability
Other-Interview	No	Printable Only
Other-Interview	No	Printable Only
Other-Interview	No	Printable Only
Other-Interview	No	Printable Only
Other-Interview	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,340

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,340	1,340
Annual IC Time Burden (Hours)	1,510	1,510
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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