Survey Screenshots

Attachment 12_SHIELD Survey Screenshots.docx

[NCHHSTP] Surveillance of HIV-related service barriers among Individuals with Early or Late HIV Diagnoses (SHIELD)

Survey Screenshots

OMB: 0920-1402

Document [docx]

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Form Approved

OMB No. 0920-New

Expiration Date: XX/XX/XXXX

Surveillance of HIV-related service barriers among Individuals with Early or Late HIV Diagnoses (SHIELD)

Attachment 12. Survey Screenshots

Public reporting burden of this collection of information is estimated to average 50 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-New)