Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Att 10_Phase 2 Consent Modified 50 13 0 Other-Consent Form (English)
Other-Consent Form (Spanish)
Phase 1 Consent Modified 2334 584 0 Other-Consent Form (English)
Other-Consent Form (Spanish)
Phase 1 Enrollment Survey A Modified 1667 1250 0 Form and Instruction n/a Phase 1 Enrollment Survey A (English)
Form and Instruction n/a Phase 1 Enrollment Survey A (Spanish)
Form and Instruction n/a Phase 1 Enrollment Survey A (screen shots)
Phase 1 Enrollment Survey B Modified 200 200 0 Form and Instruction n/a Phase 1 Enrollment Survey B (English)
Form and Instruction n/a Phase 1 Enrollment Survey B (Spanish)
Form and Instruction n/a Phase 1 Enrollment Survey B (screen shots)
Form and Instruction n/a Phase 1 Enrollment Survey B (screen shots in Spanish)
Phase 2 Behavioral Survey Modified 50 25 0 Form and Instruction n/a Phase 2 Behavioral Survey (English)
Form and Instruction n/a Phase 2 Behavioral Survey (Spanish)
Form and Instruction n/a Phase 2 Behavioral Survey (screen shots in Spanish)
Form and Instruction n/a Phase 2 Behavioral Survey (screen shots in English)
Phase 2 HIV Symptom and Care Survey Modified 450 38 0 Form and Instruction n/a Phase 2 HIV Symptom and Care Survey (English)
Form and Instruction n/a Phase 2 HIV Symptom and Care Survey (Spanish)
Form and Instruction n/a Phase 2 HIV Symptom and Care Survey (screen shots)
Form and Instruction n/a Phase 2 HIV Symptom and Care Survey (screen shots in Spanish)
Total burden requested under this ICR: 4751 2110 0  
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