[NCHHSTP] mChoice: Improving PrEP Uptake and Adherence among Minority MSM through Tailored Provider Training and Adherence Assistance in Two High Priority Settings

OMB 0920-1428

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-22FZ Clinic Assessment Every Six Months Form and Instruction
Form 0920-22FZ Clinical Assesment Baseline & Final Form and Instruction
Form 0920-22FZ Provider Interview Form and Instruction
Form 0920-22FZ Provider Post-Training Assessment Form and Instruction
Provider Pre-Training Assessment Form and Instruction
Form 0920-22FZ Provider Locator Form Form and Instruction
Form 0920-22FZ Provider Screening Form and Instruction
Form 0920-22FZ Patient Interview Guide Form and Instruction
CleverCap App Setup Form and Instruction
Patient Quarterly Assessment Form and Instruction
Patient Baseline Form and Instruction
Form 0920-22FZ Patient Locator Form Form and Instruction
Patient Screener (English/Spanish) Form and Instruction
mChoice_summary of changes memo_011024.docx Justification for No Material/Nonsubstantive Change
Att 9_Provider Training Summary.docx Supplementary Document
Att 8_Privacy Impact Assessment_mChoice.pdf Supplementary Document
Att 7_Data Use Plan mChoice.docx Supplementary Document
Att 6d_Callen_Lorde IRB reliance agreement.pdf Supplementary Document
Att 6b_University of Alabama at Birmingham IRB reliance agreement.pdf Supplementary Document
Att 6a_Columbia University IRB approval.pdf Supplementary Document
Att 5e_Provider Consent Form.pdf Supplementary Document
Att 5d_Provider Consent to Screen.pdf Supplementary Document
Att 5c_Patient Interview Consent Form Spanish.pdf Supplementary Document
Att 5c_Patient Interview Consent Form English.pdf Supplementary Document
Att 5b_Patient Consent Form Spanish.pdf Supplementary Document
Att 5b_Patient Consent Form English.pdf Supplementary Document
Att 5a_Patient Consent to Screen Spanish.pdf Supplementary Document
Att 5a_Patient Consent to Screen_CLEAN.pdf Supplementary Document
Att 3b_Provider Recruitment Materials.docx Supplementary Document
Att 3a_Patient Recruitment Materials Spanish.docx Supplementary Document
Att 3a_Patient Recruitment Materials English.docx Supplementary Document
Att 2a_60-day FRN Pub 6_13_2022.pdf Supplementary Document
Att 1_Auth Legislation.docx Supplementary Document
SSB mChoice.docx Supporting Statement B
SSA_mChoice.docx Supporting Statement A
Clinic Assessment Every Six Months Form and Instruction
Clinical Assesment Baseline & Final Form and Instruction
Provider Interview Form and Instruction
Provider Post-Training Assessment Form and Instruction
Provider Pre-Training Assessment Form and Instruction
Provider Locator Form Form and Instruction
Provider Screening Form and Instruction
Patient Interview Guide Form and Instruction
CleverCap App Setup Form and Instruction
Patient Quarterly Assessment Form and Instruction
Patient Baseline Form and Instruction
Patient Locator Form Form and Instruction
Patient Screener (English/Spanish) Form and Instruction