OMB control number

Integrating Community Pharmacists and Clinical Sites for Patient-Centered HIV Care

OMB 0920-1019 · HHS/CDC.

OMB 0920-1019

Latest forms, documents, and information collections
Document	Type
Project Staff Communication Form - medical providers	Form
Pharmacy Cost Form	Form
Clinic Staff Cost Form	Form
Project Staff Communication Form - pharmacists	Form
Key Informants Interview	Form
Pharmacy Record Abstraction Form	Form
Quarterly Patient Information Form	Form
Initial Patient Information Form	Form
Patient Demographic Information Form	Form
Project Pharmacy Characteristics Form	Form
Project Clinic Characteristics Form	Form
Att 14_ChangestoICR.docx	Supplementary Document
Att 9b_information form_spanish.docx	Supplementary Document
Att 9a_information form.docx	Supplementary Document
PS-13-1315-UNTHSC.IRB.Approval.Letter.and.Protocol-Summary.pdf	Supplementary Document
Att2 60 Day FRN.pdf	Supplementary Document
Att 1_Auth Legislation.pdf	Supplementary Document
SS B_Clean.docx	Supporting Statement B
SS A_Clean.docx	Supporting Statement A
Project Staff Communication Form - medical providers	Form
Pharmacy Cost Form	Form
Clinic Staff Cost Form	Form
Project Staff Communication Form - pharmacists	Form
Key Informants Interview	Form
Pharmacy Record Abstraction Form	Form
Quarterly Patient Information Form	Form
Initial Patient Information Form	Form
Patient Demographic Information Form	Form
Project Pharmacy Characteristics Form	Form
Project Clinic Characteristics Form	Form

Historical document collections
Reference	Filing	Received	Action
201602-0920-007	Revision of a currently approved collection	2016-02-18	Approved without change
201509-0920-012	No material or nonsubstantive change to a currently approved collection	2015-10-06	Approved without change
201505-0920-005	Revision of a currently approved collection	2015-06-04	Approved with change
201406-0920-009	No material or nonsubstantive change to a currently approved collection	2014-06-23	Approved without change
201403-0920-016	New collection (Request for a new OMB Control Number)	2014-03-28	Approved without change