Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Data Cleaning/Validation/Transmission (Strategy A) Modified 66 2640 0 Form and Instruction 0920-1072 SSuN Data Elements
Data Cleaning/Validation/Transmissions (Strategy B) Modified 66 2640 0 Form and Instruction 0920-1072 SSuN Data Elements
Record Abstraction (STD Clinics) Modified 240 960 0 Form and Instruction 0920-1072 SSuN Data Elements
SSuN Gonorrhea & Syphilis Patient Interview (Random Sampling) Modified 7000 1167 0 Form and Instruction 0920-1072 SSuN Gonorrhea and Syphilis Patient Interview & STD Clinic Patient Questionnaire
Form and Instruction 0920-1072 SSuN Data Elements
STD Clinics (Waiting Room) Survey Modified 1000 80 0 Form and Instruction 0920-1072 SSuN Gonorrhea and Syphilis Patient Interview & STD Clinic Patient Questionnaire
Form and Instruction 0920-1072 SSuN Data Elements
Total burden requested under this ICR: 8372 7487 0  
To view an IC, click on IC Title