Eligibility Consent

Web-based Approaches to Reach Black or African American and Hispanic/Latino MSM for HIV Testing and Prevention Services

OMB: 0920-1284

IC ID: 237024

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Eligibility Consent 0920-19BC
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920- Eligibility Consent Att 4a_Eligibility consent.docx Yes Yes Fillable Fileable

Health Illness Prevention

09-20-0106 "Records of Subjects in Health Promotion and Education Studies"  83 FR 6591

3,333 0
   
Individuals or Households
 
   100 %

  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 3,333 0 3,333 0 0 0
Annual IC Time Burden (Hours) 111 0 111 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 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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