Information Collection

[NCHHSTP_OPPE] Support and Scale-Up of HIV Prevention Services in Sexual Health Clinics (or SHIPS) Performance Measures

IC 272774 under ICR 202503-0920-035 · OMB 0920-1282.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1282 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
[NCHHSTP_OPPE] Support and Scale-Up of HIV Prevention Services in Sexual Health Clinics (or SHIPS) Performance Measures	Form and Instruction
SHIPS Data Entry Guide [NCHHSTP_OPPE] Support and Scale-Up of HIV Prevention Services in Sexual Health Clinics (or SHIPS) Performance Measures	Form and Instruction
Form 0920-1282 SHIPS Biannual Performance Measures [NCHHSTP_OPPE] Support and Scale-Up of HIV Prevention Services in Sexual Health Clinics (or SHIPS) Performance Measures	Form and Instruction
SHIPS Data Entry Guide Att 2- SHIPS data entry guide.pdf	Form and Instruction
SHIPS Data Entry Guide Att 1- SHIPS performance measures guide.pdf	Form and Instruction
0920-1282 SHIPS Biannual Performance Measures SHIPSBiannualPerformanceMeasure_DashboardView_3.18.25.pdf	Form and Instruction
0920-1282 SHIPS Biannual Performance Measures SHIPSBiannualPerformanceMeasure_DashboardView_3.18.25.pdf	Form and Instruction
Att 1- SHIPS performance measures guide.pdf SHIPS Performance Measures Guide	IC Document
Att 1- SHIPS performance measures guide.pdf SHIPS Performance Measures Guide	IC Document
Att 3- SHIPS Recipient Email.pdf SHIPS Recipient Email	IC Document
Att 3- SHIPS Recipient Email.pdf SHIPS Recipient Email	IC Document
Attachment 0. PPEO GenIC Request - PS24-2003_12-4-2024.pdf GenIC Request Template	IC Document
Attachment 0. PPEO GenIC Request - PS24-2003_12-4-2024.pdf GenIC Request Template	IC Document
SHIPS_Change Request Memo_EO14168_3-6-2025.docx 0920-1282 Change Request Memo 27MAR2025	IC Document
SHIPS_Change Request Memo_EO14168_3-6-2025.docx 0920-1282 Change Request Memo 27MAR2025	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

[NCHHSTP_OPPE] Support and Scale-Up of HIV Prevention Services in Sexual Health Clinics (or SHIPS) Performance Measures

Agency IC Tracking Number:

0920-1282-25BQ

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a				Yes	Yes	Fillable Fileable
Form and Instruction	0920-1282			N/A	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 75

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	75	75
Annual IC Time Burden (Hours)	57	57
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SHIPS Performance Measures Guide		12/05/2024
SHIPS Recipient Email		12/05/2024
GenIC Request Template		12/05/2024
0920-1282 Change Request Memo 27MAR2025		03/27/2025

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

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