Information Collection Request

[NCHHSTP] National HIV Behavioral Surveillance System

ICR 202605-0920-010 · OMB 0920-0770 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-0770 Behavioral Assessment for HET (Spanish) MAY2026 Form and Instruction Modified Available
Form 0920-0770 Behavioral Assessment for HET (Spanish) MAY2026 Form and Instruction Modified Repair queued
Form 0920-0770 Behavioral Assessment for HET (English) MAY2026 Form and Instruction Modified Available
Form 0920-0770 Behavioral Assessment for HET (English) MAY2026 Form and Instruction Modified Repair queued
Form 0920-0770 Behavioral Assessment for PWID (Spanish) MAY2026 Form and Instruction Modified Available
Form 0920-0770 Behavioral Assessment for PWID (Spanish) MAY2026 Form and Instruction Modified Repair queued
Form 0920-0770 Behavioral Assessment for PWID (English) MAY2026 Form and Instruction Modified Available
Form 0920-0770 Behavioral Assessment for PWID (English) MAY2026 Form and Instruction Modified Repair queued
Form 0920-0770 Recruiter Debriefing (Spanish) MAY2026 Form and Instruction Modified Available
Form 0920-0770 Recruiter Debriefing (Spanish) MAY2026 Form and Instruction Modified Repair queued
Form 0920-0770 Recruiter Debriefing (English) MAY2026 Form and Instruction Modified Available
Form 0920-0770 Recruiter Debriefing (English) MAY2026 Form and Instruction Modified Repair queued
Form 0920-0770 Behavioral Assessment for MSM (Spanish) Form and Instruction Modified Available
Form 0920-0770 Behavioral Assessment for MSM (Spanish) Form and Instruction Modified Repair queued
Form 0920-0770 Behavioral Assessment for MSM (English) MAY2026 Form and Instruction Modified Available
Form 0920-0770 Behavioral Assessment for MSM (English) MAY2026 Form and Instruction Modified Repair queued
Form 0920-0770 Eligibility Screener (Spanish) MAY2026 Form and Instruction Modified Available
Form 0920-0770 Eligibility Screener (Spanish) MAY2026 Form and Instruction Modified Repair queued
Form 0920-0770 Eligibility Screener (English) MAY2026 Form and Instruction Modified Available
Form 0920-0770 Eligibility Screener (English) MAY2026 Form and Instruction Modified Repair queued
Supporting Statement B_FINAL.docx Supporting Statement B Uploaded 2026-05-28 Available
Supporting Statement B_FINAL.docx Supporting Statement B Uploaded 2026-05-28 Repair queued
SSA_FINAL- 29May2026_CLEAN ROCIS.docx Supporting Statement A Uploaded 2026-05-29 Available
Supporting Statement A_FINAL.docx Supporting Statement A Uploaded 2026-05-28 Repair queued
Att 2b_Response to Public Comments.docx Public Comments Uploaded 2025-11-21 Available
Att 2a Public Comments.pdf Public Comments Uploaded 2025-11-21 Available
Justification Memo.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-07 Available
Justification Memo.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-07 Repair queued
Att 15_Recruiter Training Script.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 15_Recruiter Training Script.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 18_Auth to Operate for DCC.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 18_Auth to Operate for DCC.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 17_References.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 17_References.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 16_Response Rate Calculations.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 16_Response Rate Calculations.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 14_Model Recruitment Coupon.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 14_Model Recruitment Coupon.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 13_Summary of Changes to Data Collection.docx Supplementary Document Uploaded 2026-05-27 Available
Att 13_Summary of Changes to Data Collection.docx Supplementary Document Uploaded 2026-05-27 Repair queued
Att 12_Sample analysis tables.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 12_Sample analysis tables.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 11_CDC Project Determination.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 11_CDC Project Determination.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 10_Model Consent Form.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 10_Model Consent Form.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 9_List of Consultants_2025.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 9_List of Consultants_2025.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 8_NHBS Cycle Overview.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 8_NHBS Cycle Overview.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 7_Agreement to Abide by Restrictions.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 7_Agreement to Abide by Restrictions.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 6b_Privacy Impact Assessment.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 6b_Privacy Impact Assessment.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 6a_Assurance of Confidentiality.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 6a_Assurance of Confidentiality.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 5_NHBS Publications.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 5_NHBS Publications.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 2_Published 60-Day FRN.pdf Supplementary Document Uploaded 2026-05-27 Available
Att 2_Published 60-Day FRN.pdf Supplementary Document Uploaded 2026-05-27 Repair queued
Att 1_Sect 301 PHSA.PDF Supplementary Document Uploaded 2022-08-10 Available
Att 1_Sect 301 PHSA.PDF Supplementary Document Uploaded 2022-08-10 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
196958 NHBS Behavioral Assessment Survey (HET) Form and Instruction ModifiedBehavioral Assessment for HET (Spanish) MAY2026
196958 NHBS Behavioral Assessment Survey (HET) Form and Instruction ModifiedBehavioral Assessment for HET (Spanish) MAY2026
196958 NHBS Behavioral Assessment Survey (HET) Form and Instruction ModifiedBehavioral Assessment for HET (English) MAY2026
196958 NHBS Behavioral Assessment Survey (HET) Form and Instruction ModifiedBehavioral Assessment for HET (English) MAY2026
196957 NHBS Behavioral Assessment (PWID) Form and Instruction ModifiedBehavioral Assessment for PWID (Spanish) MAY2026
196957 NHBS Behavioral Assessment (PWID) Form and Instruction ModifiedBehavioral Assessment for PWID (Spanish) MAY2026
196957 NHBS Behavioral Assessment (PWID) Form and Instruction ModifiedBehavioral Assessment for PWID (English) MAY2026
196957 NHBS Behavioral Assessment (PWID) Form and Instruction ModifiedBehavioral Assessment for PWID (English) MAY2026
196956 NHBS Recruiter Debriefing Form and Instruction ModifiedRecruiter Debriefing (Spanish) MAY2026
196956 NHBS Recruiter Debriefing Form and Instruction ModifiedRecruiter Debriefing (Spanish) MAY2026
196956 NHBS Recruiter Debriefing Form and Instruction ModifiedRecruiter Debriefing (English) MAY2026
196956 NHBS Recruiter Debriefing Form and Instruction ModifiedRecruiter Debriefing (English) MAY2026
182203 NHBS Behavioral Assessment (MSM) Form and Instruction ModifiedBehavioral Assessment for MSM (Spanish)
182203 NHBS Behavioral Assessment (MSM) Form and Instruction ModifiedBehavioral Assessment for MSM (Spanish)
182203 NHBS Behavioral Assessment (MSM) Form and Instruction ModifiedBehavioral Assessment for MSM (English) MAY2026
182203 NHBS Behavioral Assessment (MSM) Form and Instruction ModifiedBehavioral Assessment for MSM (English) MAY2026
182201 NHBS Screening (All Respondent Groups) Form and Instruction ModifiedEligibility Screener (Spanish) MAY2026
182201 NHBS Screening (All Respondent Groups) Form and Instruction ModifiedEligibility Screener (Spanish) MAY2026
182201 NHBS Screening (All Respondent Groups) Form and Instruction ModifiedEligibility Screener (English) MAY2026
182201 NHBS Screening (All Respondent Groups) Form and Instruction ModifiedEligibility Screener (English) MAY2026

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2029 36 Months From Approved 05/31/2026
27,125 0 25,832
3,398 0 6,600
0 0 0





Reginfo record details
5
table that charts list of burden
IC Title Form No. Form Name
NHBS Behavioral Assessment (MSM) 0920-0770, 0920-0770 ,  
NHBS Behavioral Assessment (PWID) 0920-0770, 0920-0770 ,  
NHBS Behavioral Assessment Survey (HET) 0920-0770, 0920-0770 ,  
NHBS Recruiter Debriefing 0920-0770, 0920-0770 ,  
NHBS Screening (All Respondent Groups) 0920-0770, 0920-0770 ,  

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 27,125 25,832 0 1,293 0 0
Annual Time Burden (Hours) 3,398 6,600 0 -3,202 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No