Participants in Cross-sectional Comparison of Several POC NATs - ROI Form

[NCHHSTP] The GAIN (Greater Access and Impact with NAT) Study: Improving HIV Diagnosis, Linkage to Care, and Prevention Services with HIV Point-of-Care Nucleic Acid Tests (NATs)

Documents and Forms

Document Name Document Type
Participants in Cross-sectional Comparison of Several POC NATs - ROI Form Form and Instruction
Release of Information Form Att 14_GAIN ROI Form.pdf Form and Instruction
Release of Information Form Att 14_GAIN ROI Form.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Participants in Cross-sectional Comparison of Several POC NATs - ROI Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Release of Information Form	Att 14_GAIN ROI Form.pdf		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 333	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	333	333
Annual IC Time Burden (Hours)	56	56
Annual IC Cost Burden (Dollars)	1,062	1,062

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.