Information Collection Request

National HIV Behavioral Surveillance System

ICR 201909-0920-001 · OMB 0920-0770 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-0770 NHBS Behavioral Assessment Survey (HET) Form and Instruction Modified Available
Form 0920-0770 NHBS Behavioral Assessment (IDU) Form and Instruction Modified Available
Form 0920-0770 NHBS Recruiter Debriefing Form and Instruction Modified Available
Form 0920-0770 NHBS Behavioral Assessment (MSM) Form and Instruction Modified Available
Form 0920-0770 NHBS Screening (All Respondent Groups) Form and Instruction Modified Available
Att 18_Auth to Operate for DCC.pdf Supplementary Document Uploaded 2019-09-27 Available
Att 17_References.docx Supplementary Document Uploaded 2019-09-27 Available
Att 16_Response rate calculations.docx Supplementary Document Uploaded 2019-09-27 Available
Att 14_Model recruitment coupon.docx Supplementary Document Uploaded 2019-09-27 Available
Att 13_Summary of Changes to Data Collection.docx Supplementary Document Uploaded 2019-09-27 Available
Att 12_Sample analysis tables.pdf Supplementary Document Uploaded 2019-09-27 Available
Att 11_CDC IRB determination.pdf Supplementary Document Uploaded 2019-09-27 Available
Att 10_Model Consent Form.docx Supplementary Document Uploaded 2019-09-27 Available
Att 9_Consultants.pdf Supplementary Document Uploaded 2019-09-27 Available
Att 8_NHBS cycle overview.pdf Supplementary Document Uploaded 2019-09-27 Available
Att 7_Agreement to abide by restrictions.docx Supplementary Document Uploaded 2019-09-27 Available
Att 6b_PIA Form NHBS.pdf Supplementary Document Uploaded 2019-09-27 Available
Att 6a_Assurance of Confidentiality.pdf Supplementary Document Uploaded 2019-09-27 Available
Att 5_NHBS Publications.docx Supplementary Document Uploaded 2019-09-27 Repair queued
Att 2 60 Day FRN.pdf Supplementary Document Uploaded 2019-09-27 Available
Att 1_PHSA.pdf Supplementary Document Uploaded 2019-09-27 Available
Supporting Statement B final.docx Supporting Statement B Uploaded 2019-09-27 Repair queued
Supporting Statement A final.docx Supporting Statement A Uploaded 2019-09-27 Available

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
01/31/2023 36 Months From Approved 05/31/2020
31,668 0 29,136
8,195 0 9,138
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 31,668 29,136 0 2,532 0 0
Annual Time Burden (Hours) 8,195 9,138 0 -943 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No