OMB control number

Cooperative Re-Engagement Controlled Trial (CoRECT)

OMB 0920-1133 · HHS/CDC.

OMB 0920-1133

Latest forms, documents, and information collections
Document	Type
Annual Cost Analysis - clinic	Form
Annual cost analysis - health department	Form
Start up cost analysis - clinic	Form
Start-up cost analysis - health department	Form
Cost analysis- baseline	Form
Participant Eligibility Disposition	Form
Case Conference Form for Health Department	Form
Case Conference Form for Clinic Managers	Form
Standard of Care Survey	Form
Barriers to Care Survey	Form and Instruction
Justification 0920-1133_2 9 2017.docx	Justification for No Material/Nonsubstantive Change
Supporting Statement A.docx	Supporting Statement A
CoRECT protocol_May_21_2015.docx	Supplementary Document
Attachment 17_ Yale University IRB letter.pdf	Supplementary Document
Att 16_Philadelphia IRB approval.pdf	Supplementary Document
Att 15_MA IRB approval 11_17_15.pdf	Supplementary Document
Att 14_ State of Connecticut Project CoRECT IRB Approval.pdf	Supplementary Document
Att 2_60 Day FRN.pdf	Supplementary Document
Att 1_Auth Legislation.docx	Supplementary Document
Supporting Statement B.docx	Supporting Statement B
Annual Cost Analysis - clinic	Form
Annual cost analysis - health department	Form
Start up cost analysis - clinic	Form
Start-up cost analysis - health department	Form
Cost analysis- baseline	Form
Participant Eligibility Disposition	Form
Case Conference Form for Health Department	Form
Case Conference Form for Clinic Managers	Form
Standard of Care Survey	Form
Barriers to Care Survey	Form and Instruction
Transmittal of Clinic Variables	Other-Variable list
Transmittal of Surveilance Variables	Other-Variable list

Historical document collections
Reference	Filing	Received	Concluded	Action
201702-0920-002	No material or nonsubstantive change to a currently approved collection	2017-02-10		Approved without change
201603-0920-004	New collection (Request for a new OMB Control Number)	2016-03-10		Approved with change