Aim 2a Cohort Follow Up Survey (English/Spanish)

[NCHHSTP] Expanding PrEP in Communities of Color (EPICC)

OMB: 0920-1423

IC ID: 263128

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Aim 2a Cohort Follow Up Survey (English/Spanish) 0920-1423-24BY
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction MOD00003217 Aim 2a Cohort Follow Up Survey English Att 4k_Aim2aCohortFollowUpSurveyEnglish CLEAN.docx Yes Yes Fillable Fileable
Form and Instruction 0920-1423-24BY Encuesta de seguimiento de cohortes (Aim2aCohortFollowUpSurveySpanish) Att 4k.a_Aim2aCohortFollowUpSurveySpanish CLEAN.docx Yes Yes Fillable Fileable

Workforce Management Training and Employment

 

134 0
   
Individuals or Households
 
   0 %

  Requested 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 134 0 0 0 0 134
Annual IC Time Burden (Hours) 302 0 0 0 0 302
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att 4k.1_Aim 2a Cohort Follow-UP Survey (TC) Att 4k.1_Aim2aCohortFollowUpSurveyEnglish(TC).docx 01/05/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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