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
Baseline Survey
New
1200
400
0
Form and Instruction
0920-
Baseline Survey
Eligibility Consent
New
3333
111
0
Form and Instruction
0920-
Eligibility Consent
Eligibility Screener
New
3333
111
0
Form and Instruction
0920-
Eligibility Screener
Final HIV Test Result Survey (completion)
New
1000
83
0
Form and Instruction
0920-
Final HIV Test Result Survey
Follow-up
New
1000
500
0
Form and Instruction
0920-
Follow-up Survey
Guest Consent Form
New
667
22
0
Form and Instruction
0920-
Guest Consent
Guest HIV Test Result Survey
New
667
56
0
Form and Instruction
0920-
Guest HIV Test Result Survey
Initial HIV Test Result Survey
New
1000
83
0
Form and Instruction
0920-
Initial HIV Test Result Survey
Product Ordering
New
400
20
0
Form and Instruction
0920-
Product Ordering
Registration Contact Information
New
1267
42
0
Form and Instruction
0920-
Registration Contact Information
Study Consent
New
1333
89
0
Form and Instruction
0920-
Study Consent
Total burden requested under this ICR:
15200
1517
0
To view an IC, click on IC Title
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