Phase 1 Enrollment Survey

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 0920-1100
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1100 Att 7a_Phase 1 Enrollment Survey (English) Prt2 Wrksht_att 7_Phase 1 Enrollment Survey.pdf Yes Yes Fillable Fileable
Form and Instruction 0920-1100 Att 7b_Phase 1 Enrollment Survey (Spanish) Att 7b_Phase 1 Enrollment Survey (Spanish).docx Yes Yes Fillable Fileable
Other-Screenshot Att 12a_Screenshots_REDCaP_Phase 1 Enrollment Survey.pdf Yes Yes Printable Only

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

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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