OMB control number

[NCHHSTP] Surveillance of HIV-related service barriers among Individuals with Early or Late HIV Diagnoses (SHIELD)

OMB 0920-1402 · HHS/CDC.

OMB 0920-1402

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-1402 Attachment 6D SHIELD Qualitative IDI Guide (Spanish)Form and Instruction
Form 0920-1402 In-depth Interview – Spanish (Att 6d)Form and Instruction
Form 0920-1402 Attachment 6C SHIELD Qualitative IDI Guide (English)Form and Instruction
Form 0920-1402 In-depth Interview – English (Att 6c)Form and Instruction
Form 0920-1402 Attachment 5D SHIELD QUAL Model Consent (Spanish)Form and Instruction
Form 0920-1402 Consent for qualitative interview - Spanish (Att 5d)Form and Instruction
Form 0920-1402 Attachment 5c SHIELD Model Qual Consent (English)Form and Instruction
Form 0920-1402 Consent for qualitative interview– English (Att 5c)Form and Instruction
Form 0920-1402 Attachment 6B SHIELD Survey SPANISHForm and Instruction
Form 0920-1402 SHIELD Survey (Spanish)Form and Instruction
Form 0920-1402 Attachment 6A SHIELD Survey (English)Form and Instruction
Form 0920-1402 SHIELD Survey (English)Form and Instruction
Form 0920-1402 Attachment 5B SHIELD Model Consent (Spanish)Form and Instruction
Form 0920-1402 SHIELD Model Consent (Spanish)Form and Instruction
Form 0920-1402 Attachment 5A SHIELD Model and Actual Consent (English)Form and Instruction
Form 0920-1402 SHIELD Model Consent (English)Form and Instruction
Form 0920-1402 Attachment 4b SHIELD Quantitative Recruitment Script (Spanish)Form and Instruction
Form 0920-1402 SHIELD Model Recruitment Script (Spanish)Form and Instruction
Form 0920-1402 Attachment 4a SHIELD Quantitative Recruitment Script (English)Form and Instruction
Form 0920-1402 SHIELD Recruitment Script (English)Form and Instruction
Justification Memo for Nonsubstantive Change Req_0920-1402 SHIELD.docxJustification for No Material/Nonsubstantive Change
Attachment 8 SHIELD External Consultants.docxSupplementary Document
Attachment 10 Agreement To Abide by Restrictions on Release of Surveillance Data_clean.docxSupplementary Document
Attachment 3 SHIELD References.docxSupplementary Document
Attachment 11 PIA-No PII Collected.pdfSupplementary Document
Privacy Act Checklist.docxSupplementary Document
Attachment 7 SHIELD Project Determination.docxSupplementary Document
Attachment 2 SHIELD 60-Day FRN.pdfSupplementary Document
Attachment 1_Authorizing Legislation.pdfSupplementary Document
SSB Project Shield_clean.docxSupporting Statement B
SSA Project Shield_clean.docxSupporting Statement A
Attachment 9 Assurance of Confidentiality for HIV Surveillance.docxSupplementary Document
In-depth Interview – Spanish (Att 6d) Form and Instruction
In-depth Interview – Spanish (Att 6d) Form and Instruction
In-depth Interview – English (Att 6c) Form and Instruction
In-depth Interview – English (Att 6c) Form and Instruction
Consent for qualitative interview - Spanish (Att 5d) Form and Instruction
Consent for qualitative interview - Spanish (Att 5d) Form and Instruction
Consent for qualitative interview– English (Att 5c) Form and Instruction
Consent for qualitative interview– English (Att 5c) Form and Instruction
SHIELD Survey (Spanish) Form and Instruction
SHIELD Survey (Spanish) Form and Instruction
SHIELD Survey (English) Form and Instruction
SHIELD Survey (English) Form and Instruction
SHIELD Model Consent (Spanish) Form and Instruction
SHIELD Model Consent (Spanish) Form and Instruction
SHIELD Model Consent (English) Form and Instruction
SHIELD Model Consent (English) Form and Instruction
SHIELD Model Recruitment Script (Spanish) Form and Instruction
SHIELD Model Recruitment Script (Spanish) Form and Instruction
SHIELD Recruitment Script (English) Form and Instruction
SHIELD Recruitment Script (English) Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202503-0920-026 No material or nonsubstantive change to a currently approved collection 2025-05-28
202403-0920-003 Revision of a currently approved collection 2024-03-22 Approved with change
202301-0920-007 New collection (Request for a new OMB Control Number) 2023-02-10 Approved without change