View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Field Assessment of a Comprehensive Manual for Hepatitis C Counseling and Testing
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Recruitment Script Attach 1 HCV Field Assessment Recruitment Script.docx No No Paper Only
Form none Interview Attach 3 Field Assessment Wrap-up Interview questions.docx No No Paper Only
Form none Check-in Questions Attach 2 Field Assessment Telephone Check-in questions.docx No No Paper Only

Health Consumer Health and Safety

 

40 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 240 0 0 0 0 0
Annual IC Time Burden (Hours) 70 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement B Supporting Statement - Part B.docx 02/02/2012
Supporting Statement A Supporting Statement Part A.docx 02/02/2012
Informed Consent Attach 5 HCV Field Assessment Informed Consent.docx 02/02/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.