View Information Collection (IC)
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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Internet Partner Service Activities and Guidelines for HIV Testing at Refugee Screening
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
none
ISP PM Data Collection
IPS_Att. A_PM Data Collection Instrument.docx
No
No
Fillable Fileable
Form
none
ISP Assessment
IPS_Att. C- DIS IPS Assessment_Web version.docx
Yes
Yes
Fillable Fileable
Form
none
Assessment of Guidelines for HIV Testing in Refugees
HIV_Att C_Data Collection Instrument_Web version.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
925
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
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
925
0
0
0
0
0
Annual IC Time Burden (Hours)
372
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
IPS Email for DIS ISP
IPS_Att E_Email notification for DIS IPS Assessment.docx
02/06/2014
ISP DIS Day 5 Reminder
IPS_Att. F_Day 5 Reminder email to DIS.docx
02/06/2014
IPS DIS 10 Day Reminder
IPS_Att. G_Day 10 reminder email to DIS.docx
02/06/2014
ISP DIS Assessment Word Version
IPS_Att. B_DIS IPS Assessment.docx
02/07/2014
ISP PM Follow-up Reminder
IPS_Att. D_ PM Follow Up Email.docx
02/07/2014
HIV - Supporting Statement B
HIV- Supporting_Statement_B.docx
02/10/2014
HIV - Att A - Refugee Screening Exam Keypoints
HIV_Att. A- Refugee HIV Screening Exam.pdf
02/10/2014
HIV - Att B - Assessment - Word
HIV_Att B_Data Collection Instrument.docx
02/10/2014
HIV - Att D - Email Notification
HIV_Att. D-Notification Email.docx
02/10/2014
HIV - Att E - Reminder Email
HIV_Att. E -Reminder Email.docx
02/10/2014
HIV - Att F - Reminder Email
HIV_Att. F-FINAL Reminder Email.docx
02/10/2014
HIV - Att G - Follow-up Email
HIV_Att. G-Follow up Email.docx
02/10/2014
HIV - Supporting Statement A
HIV- Supporting_Statement_A.docx 2 10 14.docx
02/10/2014
ISP Supporting Statement Part B
IPS_Supporting Statement B.docx
02/10/2014
ISP Supporting Statement Part A
IPS_Supporting Statement A.docx
02/10/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.