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

View Information Collection (IC)

Harm Reduction Point in Time Survey PILOT
 
New
 
Voluntary
 
5 CFR 1320.8(d)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Point in Time Reduction Survey Paper Version Yes Yes Fillable Fileable
Form and Instruction Point in Time Reduction Survey Tablet Version Yes Yes Fillable Fileable

Health Public Health Monitoring

Privacy Act of 1974 (Title 5 United States Code [U.S.C.] 552a)  75 FR 28264

26 0
   
State, Local, and Tribal Governments
 
   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 26 0 26 0 0 0
Annual IC Time Burden (Hours) 18 0 18 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Survey Consent Form 04/30/2024
Incentive Tracking and Acknowledgement 04/30/2024
Survey Checklist 04/30/2024
Survey Recruitment Script 04/30/2024
Daily Outreach Refusal Tracking Form 04/30/2024
Survey Participant Tracking 04/30/2024
Debriefing Interview Guide 04/30/2024
Tablet User Agreement 04/30/2024
Confidentiality Agreement 04/30/2024
Training Protocols 04/30/2024
Point in Time Harm Reduction PILOT Generic Request Template 04/30/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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