Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Eligibility Screener Modified 1700 142 0 Form 0920-24DF Eligibility Screener English
Form 0920-24DF Eligibility Screener Spanish
Form 0920-25-0073 Eligibility Screener English
Form 0920-25-0073 Eligibility Screener Spanish
Focus Group Consent Modified 48 72 0 Form 0920-24DF Focus Group Consent English
Form 0920-24DF Att 5b_Focus Group Consent Spanish_clean
HIV sample collection Modified 1700 567 0 Form and Instruction n/a HIV Sample Collection
Form and Instruction n/a HIV Sample Collection (Spanish)
In-Depth Interview Unchanged 45 45 0 Form 0920-24DF In-Depth Interview Consent English
Form 0920-24DF In-Depth Interview Consent Spanish
Quarterly Assessment Modified 3400 2550 0 Form 0920-24DF Quarterly assessment English
Form 0920-24DF Quarterly assessment Spanish
Form 0920-25-0073 Quarterly assessment English
Form 0920-25-0073 Quarterly assessment Spanish
Registration Contact Information Form Modified 425 35 0 Form 0920-24DF Registration Contact Information Form English
Form 0920-24DF Registration Contact Information Form Spanish
Form 0920-25-0073 Reg Contact Info Form English
Form 0920-25-0073 Reg Contact Info Form Spanish
SMaRT App Install Modified 425 71 0 Form and Instruction n/a SMART App Installation
Form and Instruction n/a SMART App Installation (Spanish)
Form 0920-25-0073 Behavioral_Assessment_HET_Spanish
Form 0920-25-0073 Behavioral_Assessment_HET_English
STI Sample Collection Unchanged 1700 850 0 Form and Instruction n/a STI Sample Collection
Form and Instruction n/a STI Sample Collection (Spanish)
Total burden requested under this ICR: 9443 4332 0  
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