Quantitative Population Eligibility Screener

[NCHHSTP] National HIV Behavioral Surveillance: Brief HIV Bio-behavioral Assessment (NHBS-BHBA)

OMB: 0920-1398

IC ID: 255844

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Quantitative Population Eligibility Screener
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Quantitative Population Eligibility Screener (English) Att 3b_Quantitative Population Eligibility Screener_Eng_20230426_clean.docx Yes Yes Fillable Fileable
Form and Instruction None Quantitative Population Eligibility Screener (Spanish) Att 4b_Quantitative Population Eligibility Screener_Spa_20220921_clean.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems HHS/CDC  76 FR 4458

1,204 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 1,204 0 0 0 0 1,204
Annual IC Time Burden (Hours) 100 0 0 0 0 100
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
© 2024 OMB.report | Privacy Policy