Information Collection Request
[NCHHSTP] Surveillance of HIV-related service barriers among Individuals with Early or Late HIV Diagnoses (SHIELD)
ICR 202301-0920-007 · OMB 0920-1402 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-1402 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 0920- SHIELD Survey (Spanish) |
Form | New | Repair queued |
| Form 0920- SHIELD Survey (English) |
Form | New | Repair queued |
| Form 0920- SHIELD Model Consent (Spanish) |
Form | New | Repair queued |
| Form 0920- SHIELD Model Consent (English) |
Form | New | Repair queued |
| Form 0920- SHIELD Model Recruitment Script (Spanish) |
Form | New | Repair queued |
| Form 0920- SHIELD Recruitment Script (English) |
Form | New | Repair queued |
 30dy2323HK Published.pdf |
Supplementary Document | Uploaded 2023-02-07 | Repair queued |
 SSB Project Shield .docx |
Supporting Statement B | Uploaded 2023-01-18 | Repair queued |
| SSA Project Shield_22HK CB.docx |
Supporting Statement A | Uploaded 2023-01-18 | Repair queued |
| Att 11_Agreement To Abide by Restrictions on Release of Surveillance Data.docx |
Supplementary Document | Uploaded 2023-01-18 | Repair queued |
| Att 10_Assurance of Confidentiality for HIV Surveillance.docx |
Supplementary Document | Uploaded 2023-01-18 | Repair queued |
| Att 9_SHIELD External Consultants.docx |
Supplementary Document | Uploaded 2023-01-18 | Repair queued |
| Att 7_SHIELD Project Determination.docx |
Supplementary Document | Uploaded 2023-01-12 | Repair queued |
| Att 3_SHIELD References.docx |
Supplementary Document | Uploaded 2023-01-12 | Repair queued |
| Att 1_Authorizing Legislation.pdf |
Supplementary Document | Uploaded 2023-01-12 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 257895 |  SHIELD Survey (Spanish) |
Form | New | |
| 257894 | SHIELD Survey (English) |
Form | New | |
| 257893 | SHIELD Model Consent (Spanish) |
Form | New | |
| 257892 | SHIELD Model Consent (English) |
Form | New | |
| 257891 | SHIELD Model Recruitment Script (Spanish) |
Form | New | |
| 257890 | SHIELD Recruitment Script (English) |
Form | New |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-1402 |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Agency Tracking No | 0920-22HK |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |