Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Counseling, Testing and Referral for Community-Based Organizations Modified 400 12000 0 Form and Instruction none HIV test form - page 1
Form and Instruction none HIV test form - page 2
Form and Instruction none HIV test form - page 3
Form and Instruction none HIV test form - Pacific Islands
Counseling, Testing and Referral for Health Jurisdictions (CTR scan) Modified 120 73920 0 Form and Instruction none HIV test scan form - page 3
Form and Instruction none HIV test scan form - page 1
Form and Instruction none HIV test scan form - page 2
Form and Instruction none HIV test scan form - Pacific Islands
PEMS Data Collection for Community-Based Organizations Modified 1200 100800 0 Form none NHM&E variables
PEMS Data Collection for Community-Based Organizations (Training) Modified 1200 12000 0 Form none NHM&E variables
PEMS Data Collection for Health Jurisdictions Modified 260 38428 0 Form none NHM&E Variables
PEMS Data Collection for Health Jurisdictions (HIV testing non-scan) Modified 140 61460 0 Form none NHM&E variables
PEMS Data Collection for Health Jurisdictions (Training) Modified 260 2600 0 Form none NHM&E variables
Total burden requested under this ICR: 3580 301208 0  
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