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Federal forms, ICRs, and supporting documents

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HIV Prevention and Treatment Services among Young Men of Color who Have Sex with Men (YMSM of Color) and Young Transgender Persons of Color (YTG of Color) in the Deep South"

IC 235907 under ICR 202010-0920-010 · OMB 0920-1091.

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

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HIV Prevention and Treatment Services among Young Men of Color who Have Sex with Men (YMSM of Color) and Young Transgender Persons of Color (YTG of Color) in the Deep South" 0920-1091-19ATS
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-1091 Deep South Client Screener (English) Att 3a_Deep South Client Screener 3 26 2019.docx No   Fillable Printable
Form and Instruction 0920-1091 Deep South CBO Client Interview Guide Att 3b_Deep South Client Interview Guide 3 26 2019.docx No   Paper Only
Form and Instruction 0920-1091 Deep South Staff Interview Guide Att 3c_Deep South Staff Interview Guide.docx No   Paper Only

Health Illness Prevention

 

444 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 444 0 0 0 0 444
Annual IC Time Burden (Hours) 177 0 0 0 0 177
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att 1_ Deep South Recruitment Flyers Att 1_Deep South Recruitment Flyers.pdf 04/30/2019
Att 2_Deep South Informed Consent Att 2_Deep South Informed Consent Forms.docx 04/30/2019
Att 4a _CDC IRB Approval Att 4a_CDC IRB Approval Protocol 7152 Approval.docx 04/30/2019
Att 4b_Emory IRB Determination Att 4b_Emory U IRB Determination.pdf 04/30/2019
Att 5_Data Use Plan Att 5_Deep South Data Use Plan.doc 04/30/2019
Att 6_Privacy Impact Assessment Att 6_Privacy Impact Assessment Approval.pdf 04/30/2019
2018 iQualR PIA 2018 iQualR PIA_signed 3 26 2019.pdf 04/30/2019
Supporting Statement A SSA - HIV Prevention and Treatment (YMSM of Color) (YTG of Color) 0920-1091 3 26 2019.docx 04/30/2019
Supporting Statement B SS B.docx 04/30/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.