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Form 0920-1402 Attachment 5A SHIELD Model and Actual Consent (English)
[NCHHSTP] Surveillance of HIV-related service barriers among Individuals with Early or Late HIV Diagnoses (SHIELD)
Attachment 5A SHIELD Model and Actual Consent (English)
SHIELD Model Consent (English)
OMB: 0920-1402
OMB.report
HHS/CDC
OMB 0920-1402
ICR 202403-0920-003
IC 257892
Form 0920-1402 Attachment 5A SHIELD Model and Actual Consent (English)
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⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-1402 can be found here:
2025-05-28 - No material or nonsubstantive change to a currently approved collection
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