M&E Data Elements on HIV Prevention and Care Services (THRIVE Partners)

Comprehensive HIV Prevention and Care for Men Who Have Sex with Men of Color

Documents and Forms

Document Name Document Type
Att 4_ME Variables.docx Other-Data elements

Information Collection (IC) Details

IC Title:	M&E Data Elements on HIV Prevention and Care Services (THRIVE Partners)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Data elements			Att 4_ME Variables.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemiologic studies and surveillance of disease problems	FR Citation: 57 FR 62812

Number of Respondents: 80	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	160	160
Annual IC Time Burden (Hours)	1,440	1,440
Annual IC Cost Burden (Dollars)	37,224	37,224

Documents for IC

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.