OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Community Screener - Screened Injection Drug Users and High-risk heterosexual individuals

IC 200567 under ICR 201203-0920-006 · OMB 0920-0922.

Documents and Forms
Document Name
Document Type
Instruction
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Community Screener - Screened Injection Drug Users and High-risk heterosexual individuals
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Rev Attach 3a Eligibility Screener-Community Survey.docx Yes Yes Printable Only

Health Immunization Management

 

1,500 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Requested 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 1,500 0 0 0 0 1,500
Annual IC Time Burden (Hours) 125 0 0 0 0 125
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attach 7b _Venue Owner_Manager Script. Attach 7b _Venue Owner_Manager Script.doc 02/15/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.