Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2018 Congenital Syphilis Study New 220 220 0 Form and Instruction 0920-0840 Eligibility Screener - Prenatal Care Providers
Form and Instruction 0920-0840 Interview Guide - Prenatal Care Providers
Form and Instruction 0920-0840 Eligibility Sreener - Pregnant Women
Form and Instruction 0920-0840 Interview Guide - Pregnant Women
Assessment of STD Service Needs and Provisions New 5025 421 0 Form none Patient Questionnaire
Form none Administrative Questionnaire
Developing Tools to Engage Adolescent Men Who Have Sex with Men (AMSM) New 72 198 0 Form and Instruction n/a Screener for In-person AMSM and Transgender Focus Groups
Form n/a Screener for Online AMSM and Transgender Focus Groups
Form and Instruction n/a AMSM Focus Group Guide
Form n/a Screenshots of AMSM Focus Group Guide
Form and Instruction n/a Transgender Youth Focus Group Guide
Form n/a Screenshots of Transgender Youth Focus Group Guide
Development of a Mobile Messaging Intervention for Men who have Sex with Men: Formative Study New 848 243 0 Form and Instruction NA Eligibility Screening Form - Online
Form and Instruction NA Contact Information Form - Online
Form and Instruction NA Eligibility Screening Form - Reverification
Form and Instruction NA Focus Group Guide
Form and Instruction NA In-Depth Interview Guide
Examination of Jail and Prison Policies Related to STD Prevention New 24 28 0 Form and Instruction NA Vulnerable Populations Project Key Informant Interview Guide
Formative Research on Resilience and Transgender Youth New 48 73 0 Form and Instruction N/A Qualitative Interview Guide
Form and Instruction N/A Eligibility Screener
Formative Tools for Addressing HIV Prevention Preferences among Adolescent MSM New 7875 1677 0 Form none Survey screener
Form none Survey - word
Form none Survey AMSM - screenshots
Form none Survey Trans - screenshots
Improving Surveillance Data Collection among Persons Not Receiving HIV Care: A Qualitative Project to Enhance the MMP New 40 40 0 Form 0920-0840 Interview Guide
Middle School Perspectives on Sexual Health Education in Fort Worth Independent School District New 48 72 0 Form and Instruction N/A Middle School Focus Group Guide
Project Engage 2.0: Engaging Gay "Community" Activism for Syphilis Prevention New 192 107 0 Other-WORD
Other-WORD
Project Engage: Engaging Gay "Community" Activism for Syphilis Prevention New 100 45 0 Form and Instruction NA Eligibility Screener
Form and Instruction NA Telephone Interview Guide
Student and Teacher Perspectives on Sexual Health Education in Fort Worth Independent School District New 126 174 0 Form and Instruction 0920-16ML Att 2-Teacher Interview Guide
Instruction
Form and Instruction 0920-16ML Att 4-Middle School Student Focus Group Guide
Form and Instruction 0920-16ML Att 5-High School Student Focus Group Guide
Form and Instruction 0920-16ML Att 8-Teacher Interview Consent Form
Instruction
Instruction
Instruction
Instruction
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 14618 3298 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title