Study Visit Survey

The GAIN (Greater Access and Impact with NAT) Study: Improving HIV Diagnosis, Linkage to Care, and Prevention Services with HIV Point-of-Care Nucleic Acid Tests (NATs)

Att 11_GAIN study visit survey_screenshots

Participants in Cross-sectional Comparison of Several POC NATs - Study Visit Survey

OMB: 0920-1357

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OMB No. 0920-New

Expiration Date: XX/XX/XXXX





Public reporting burden of this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-New)

























If HIV status negative or unknown:

If HIV status positive:

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorLisa A Niemann
File Modified0000-00-00
File Created2021-06-29

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