Information Collection Request
Medical Report with Allegation of Human Immunodeficiency Virus (HIV) Infection--Adult and Child
ICR 202306-0960-004 · OMB 0960-0500 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0960-0500 can be found here:
Forms and Documents
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 9396 |  Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection |
Form and Instruction | Modified | |
| 9396 | Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection |
Form and Instruction | Modified | |
| 187514 | Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection |
Form and Instruction | Modified | |
| 187514 | Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection |
Form and Instruction | Modified |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | SSA |
| OMB Control No | 0960-0500 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202204-0960-008 |
| Date Submitted to OIRA | 2023-06-30 |
| Requested Expiration Date | 1969-12-31 |