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
Modified
18750
2500
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
120
20
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:
18870
2520
0
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