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Patient Baseline
[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: 263488
OMB.report
HHS/CDC
OMB 0920-1428
ICR 202402-0920-005
IC 263488
( )
Documents and Forms
Document Name
Document Type
Patient Baseline
Form and Instruction
Att 4c_Patient Baseline Assessment English.docx
Att 4c_Patient Baseline Assessment_CLEAN.docx
Form and Instruction
Att 4c_Patient Baseline Assessment Spanish
Att 4c_Patient Baseline Assessment Spanish_CLEAN.docx
Form and Instruction
Information Collection (IC) Details
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