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

View Information Collection (IC)

Feasibility of HIV Behavioral Surveillance for Young MSM
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0840 Attachment 4_Recruitment Debriefing Attachment 4_Recruitment Debriefing.doc Yes Yes Printable Only
Form and Instruction 0920-0840 Attachment 5_Eligibility Screener Attachment 5_Eligibility Screener.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0840 Attachment 6_Behavioral Assessment Attachment 6_Behavioral Assessment.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0840 Attachment 7_Key informant interview Attachment 7_Key informant interview.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0840 Attachment 8_Focus Group Interview Attachment 8_Focus Group Interview.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0840 Attachment 9_Enumeration Interview Attachment 9_Enumeration Interview.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0840 Attachment 10_Landing Page and Banner Ad Attachment 10_Landing Page and Banner Ad.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

5,446 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 5,446 0 0 0 0 0
Annual IC Time Burden (Hours) 1,715 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement_Part A Supporting Statement_Part A.docx 12/30/2013
Supporting Statement_Part B Supporting Statement_Part B.docx 12/30/2013
Attachment 1_Sect 301 PHSA Attachment 1_Sect 301 PHSA.doc 12/30/2013
Attachment 2_DCC authorization to operate Attachment 2_DCC authorization to operate.docx 12/30/2013
Attachment 3_Recruiter Training Script Attachment 3_Recruiter Training Script.docx 12/30/2013
Attachment 11_Assurance of Confidentiality Attachment 11_Assurance of Confidentiality.docx 12/30/2013
Attachment 12_Agreement to abide by restrictions Attachment 12_Agreement to abide by restrictions.doc 12/30/2013
Attachment 13_Assent and Consent Forms Attachment 13_Assent and Consent Forms.docx 12/30/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.