Eligibility Screening

Evaluation of TransLife Center (TLC): A Locally-Developed Combination Prevention Intervention for Transgender Women at High Risk of HIV Infection

OMB: 0920-1246

IC ID: 232928

Information Collection (IC) Details

View Information Collection (IC)

Eligibility Screening
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form n/a TLC Eligibility Screener Att 4a_TLC Eligibility Screener_23Aug2018.docx No   Paper Only

Health Illness Prevention

09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems HHS/CDC  57 FR 62812

150 0
   
Individuals or Households
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 150 0 150 0 0 0
Annual IC Time Burden (Hours) 10 0 10 0 0 0
Annual IC Cost Burden (Dollars) 243 0 243 0 0 0

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

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