OMB
.report
Search
Informed Consent
The Prevalence and Incidence of HIV Molecular Variants and Their Correlation with Risk Behaviors and HIV Treatment in Brazilian Blood Donors (NHLBI)
OMB: 0925-0597
IC ID: 215802
OMB.report
HHS/NIH
OMB 0925-0597
ICR 201503-0925-008
IC 215802
( )
Documents and Forms
Document Name
Document Type
Form 1
Informed Consent
Form and Instruction
Attach_6_Risk_Factor_Informed_Consent_Portuguese_2_2015_V_2.0.docx
Other-Portuguese Inform Consent
1 Attachment 2 Risk Factor Informed Consent
Attach_2_Risk_Factor_Informed Consent_2_2015_V_2.0.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Informed Consent
Agency IC Tracking Number:
Is this a Common Form?
No
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 and Instruction
1
Attachment 2 Risk Factor Informed Consent
Attach_2_Risk_Factor_Informed Consent_2_2015_V_2.0.docx
Yes
Yes
Fillable Fileable
Other-Portuguese Inform Consent
Attach_6_Risk_Factor_Informed_Consent_Portuguese_2_2015_V_2.0.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:
100
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
100
0
100
0
0
0
Annual IC Time Burden (Hours)
8
0
8
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.