Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Data Cleaning/Validation/Reformatting Modified 11 3168 0 Other-Data Cleaning/Validation
Early Syphilis Cases (Section 2) Removed 0 0 0 Form and Instruction 0920-1072 Early Syphilis Cases (Section 2)
Early Syphilis Follow-up (Section 3) Removed 0 0 0 Form and Instruction 0920-1072 Early Syphilis Follow-up (Section 3)
Gonorrhea Patient Interview (Section 1) Modified 7380 1230 0 Form and Instruction 0920-1072 Gonorrhea Patient Interview section 1
HIV registry matching New 11 880 0 Other-HIV Registry
Record Abstraction Modified 11 264 0 Other-Data Elements
STD Clinic Survey New 3850 321 0 Form and Instruction 0920-1072 STD Interview
Total burden requested under this ICR: 11263 5863 0  
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