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2018 National Ryan White Conference on HIV Care & Treatment Evaluation
Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration
OMB: 0915-0212
IC ID: 233091
OMB.report
HHS/HSA
OMB 0915-0212
ICR 202012-0915-001
IC 233091
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:
2024-01-10 - Revision of a currently approved collection
2024-01-04 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
2018 National Ryan White Conference on HIV Care & Treatment Evaluation
Form and Instruction
1 Ryan White 2018 Session Evaluation 9.18.2018 FINAL2.pdf
Ryan White 2018 Session Evaluation 9.18.2018 FINAL2.pdf
Form and Instruction
2 Breakout Session Evaluation Questions_final.docx
Breakout Session Evaluation Questions_final.docx
Form and Instruction
3 Plenary Session Evaluation Questions_final.docx
Plenary Session Evaluation Questions_final.docx
Form and Instruction
4 Overall 2018 NRWC Evaluation_final.docx
Overall 2018 NRWC Evaluation_final.docx
Form and Instruction
Supporting Statement NRWC 2018_final.docx
Supporting Statment A
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
2018 National Ryan White Conference on HIV Care & Treatment Evaluation
Agency IC Tracking Number:
IC Status:
Unchanged
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
Form and Instruction
1
Ryan White 2018 Session Evaluation 9.18.2018 FINAL2.pdf
Ryan White 2018 Session Evaluation 9.18.2018 FINAL2.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
2
Breakout Session Evaluation Questions_final.docx
Breakout Session Evaluation Questions_final.docx
Yes
Yes
Fillable Fileable
Form and Instruction
3
Plenary Session Evaluation Questions_final.docx
Plenary Session Evaluation Questions_final.docx
Yes
Yes
Fillable Fileable
Form and Instruction
4
Overall 2018 NRWC Evaluation_final.docx
Overall 2018 NRWC Evaluation_final.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,125
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
18,761
0
0
0
0
18,761
Annual IC Time Burden (Hours)
526
0
0
0
0
526
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Supporting Statment A
Supporting Statement NRWC 2018_final.docx
09/20/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.