Information Collection Request
[NCHHSTP] TRANSCEND: Transgender Status-neutral Community-to-clinic Models to End the HIV Epidemic
ICR 202305-0920-002 · OMB 0920-1410 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Client Satisfaction Survey (data manager) |
Form and Instruction | New | Repair queued |
| Client Satisfaction Survey (client) |
Form and Instruction | New | Repair queued |
| Client Intake Form (client) |
Form and Instruction | New | Repair queued |
| Client Intake Form (data manager) |
Form and Instruction | New | Repair queued |
 Att4_PD_TRANSCEND_combined.pdf |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Att2 60 Day FRN Pub 11-16-2022.pdf |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
 Att 1_Authorizing Legislation.docx |
Supplementary Document | Uploaded 2023-05-25 | Repair queued |
| Supporting Statement B.docx |
Supporting Statement B | Uploaded 2023-05-25 | Repair queued |
| Supporting Statement A.docx |
Supporting Statement A | Uploaded 2023-05-25 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 260399 |  Client Satisfaction Survey (data manager) |
Form and Instruction | New | |
| 260398 | Client Satisfaction Survey (client) |
Form and Instruction | New | |
| 260397 | Client Intake Form (client) |
Form and Instruction | New | |
| 260396 | Client Intake Form (data manager) |
Form and Instruction | New | |
| 260395 | Electronic Health Record Data |
Other-Specification of Data Elements for Electronic Transfer | New |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-1410 |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Agency Tracking No | 0920-23AP |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |