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 9600 1280 0 Form and Instruction SSA-4814-F5 Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection
Other-Revised Privacy Act Statement
Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection Modified 80 13 0 Form and Instruction SSA-4815-F6 Medical Report on Child with Allegation of Human Immunodeficiency virus (HIV) Infection
Other-Revised Privacy Act Statement
Total burden requested under this ICR: 9680 1293 0  
To view an IC, click on IC Title