Clinic Assessment Every Six Months

[NCHHSTP] mChoice: Improving PrEP Uptake and Adherence among Minority MSM through Tailored Provider Training and Adherence Assistance in Two High Priority Settings

OMB: 0920-1428

IC ID: 263498

Information Collection (IC) Details

View Information Collection (IC)

Clinic Assessment Every Six Months 0920-22FZ
 
Yes New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-22FZ Att 4m_Clinic Assessment Every 6 Months Att 4m_Clinic Assessment Every 6 Months.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

4 0
   
Individuals or Households
 
   0 %

  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 8 0 8 0 0 0
Annual IC Time Burden (Hours) 12 0 12 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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