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

View Information Collection (IC)

Developing Tools to Engage Adolescent Men Who Have Sex with Men (AMSM) 0920-17AZE
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a No   Paper Only
Form n/a Yes Yes Fillable Fileable
Form and Instruction n/a No   Paper Only
Form n/a Yes Yes Fillable Fileable
Form and Instruction n/a No   Paper Only
Form n/a Yes Yes Fillable Fileable

Health Illness Prevention

09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems. HHS/CDC  57 FR 62812

72 0
   
Individuals or Households
 
   67 %

  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 72 0 72 0 0 0
Annual IC Time Burden (Hours) 198 0 198 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement Part A 10/04/2017
Supporting Statement Part B 10/04/2017
Federal Register Notice 10/04/2017
Informed Consent for Participants 18 and Over 10/04/2017
Screenshots of Informed Assent or Consent 10/04/2017
Waiver or Alteration of Informed Consent 10/04/2017
Waiver of Parental Permission 10/04/2017
Waiver of HIPAA Authorization 10/04/2017
Procedure for Reporting Suspected Child Abuse 10/04/2017
Recruitment Advertisements 10/04/2017
Online Recruitment Ad Language 10/04/2017
IRB Approval Letter 10/04/2017
Informed Assent for Participants Under 18 Years of Age 10/05/2017
CDC Research Project Determination Form 10/06/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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