OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

HIV/AIDS Bureau Core Medical Services Waiver

OMB 0915-0307 · HHS/HSA.

OMB 0915-0307

HRSA uses the documentation submitted in core medical services waiver requests to determine if the applicant/grant recipient meets the statutory requirements for waiver eligibility including: (1) No waiting lists for AIDS Drug Assistance Program (ADAP) services; and (2) evidence of core medical services availability within the grant recipient’s jurisdiction, state, or service area to all people with HIV identified and eligible under Title XXVI of the PHS Act.

The latest form for HIV/AIDS Bureau Core Medical Services Waiver expires 2022-11-30 and can be found here.

Latest Forms, Documents, and Supporting Material
Document
Name
Supplementary Document
Supporting Statement A
All Historical Document Collections
Approved without change
 Extension without change of a currently approved collection 2019-10-15
Approved without change
 Extension without change of a currently approved collection 2017-02-02
Approved without change
 Revision of a currently approved collection 2014-01-30
Approved without change
 Extension without change of a currently approved collection 2011-02-23
Approved without change
 Extension without change of a currently approved collection 2008-01-22
Approved without change
 New collection (Request for a new OMB Control Number) 2007-07-02