Screener

Understanding Decisions and Barriers about PrEP Use and Uptake Among Men Who Have Sex With Men

OMB: 0920-1245

IC ID: 232929

Information Collection (IC) Details

View Information Collection (IC)

Screener
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA PrEP Project Screener Att 3a Screener.docx NA No   Paper Only

Health Illness Prevention

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

600 0
   
Individuals or Households
 
   0 %

  Approved 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 600 0 600 0 0 0
Annual IC Time Burden (Hours) 50 0 50 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Eligibility Verification, Screener & Behavioral Assessment – Print Screens Att 3g Screener_Beh Assessment Screen Caps.docx 09/24/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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