Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Acceptability Survey Modified 21 7 0 Form 0920-25-0177 Acceptability Survey
Follow Up Phone Call Survey Modified 102 9 0 Form 0920-25-0177 Follow Up Phone Call Survey
Gay City Data Collection Modified 2 2 0 Form and Instruction 0920-25-0177 Gay City Data Collection
HIV-negative Patients Seeking HIV Testing - Study Visit Survey Removed 0 0 0 Form 0920-1357 Study Visit Survey (SCREENSHOTS)
Form 0920-1357 GAIN Study Visit Survey - Revised 09SEP2022 (SCREENSHOTS)
Madison Clinic Data Collection Modified 1 1 0 Form and Instruction 0920-25-0177 Madison Clinic Data Collection
Participant Focus Group and Interview Guide Modified 4 4 0 Form and Instruction 0920-25-0177 Participant Focus Group and Interview Guide
Provider Interview Guide Modified 18 14 0 Form and Instruction 0920-25-0177 Provider Interview Guide
RCT of POC NAT or Standard of Care for HIV-positive Patients - ROI Form Removed 0 0 0 Form and Instruction 0920-1357 Patient Authorization to Disclose, Release and/or Obtain Protected Health Information
RCT of POC NAT or Standard of Care for HIV-positive Patients - Study Visit Form Removed 0 0 0 Form 0920-1357 Study Visit Survey (SCREENSHOTS)
Form and Instruction 0920-1357 GAIN Study Visit Survey - Revised 09SEP2022 (SCREENSHOTS)
Release of Information Modified 252 2 0 Form 0920-25-0177 Release of Information
Screen and Link Modified 2 4 0 Form and Instruction 0920-25-0177 Screen and Link
Study Visit Survey Modified 21 6 0 Form 0920-25-0177 Study Visit Survey
Total burden requested under this ICR: 423 49 0  
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