PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection--Adult
Modified
46200
7700
0
Form and Instruction
SSA-4814-F5
Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection
Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection
Modified
12900
2150
0
Form and Instruction
SSA-4815-F6
Medical Report on Child with Allegation of Human Immunodeficiency virus (HIV) Infection
Total burden requested under this ICR:
59100
9850
0
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