Phase 1 Enrollment Survey B

Identification of Behavioral and Clinical Predictors of Early HIV Infection (Project DETECT)

OMB: 0920-1100

IC ID: 218945

Information Collection (IC) Details

View Information Collection (IC)

Phase 1 Enrollment Survey B
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Phase 1 Enrollment Survey B (English) Att 7a_Phase 1 Enrollment Survey B - 2021_clean.docx Yes Yes Fillable Fileable
Form and Instruction n/a Phase 1 Enrollment Survey B (Spanish) Att 7b_Phase 1 Enrollment Survey B (Spanish).docx Yes Yes Fillable Fileable
Form and Instruction n/a Phase 1 Enrollment Survey B (screen shots) Att 7a_Phase 1 Enrollment Survey B - Screenshots - 2021.docx Yes Yes Fillable Fileable
Form and Instruction n/a Phase 1 Enrollment Survey B (screen shots in Spanish) Att 12b_Screenshots_Phase1 Enrollment Survey B (Spanish).pdf Yes Yes Fillable Fileable

Health Health Care Services

 

1,867 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 1,867 0 1,667 0 0 200
Annual IC Time Burden (Hours) 934 0 734 0 0 200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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