2018 National Ryan White Conference on HIV Care & Treatment Evaluation

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Document Name Document Type
Form 1 2018 National Ryan White Conference on HIV Care & Treatment Evaluation Form and Instruction
1 Ryan White 2018 Session Evaluation 9.18.2018 FINAL2.pdf Ryan White 2018 Session Evaluation 9.18.2018 FINAL2.pdf Form and Instruction
2 Breakout Session Evaluation Questions_final.docx Breakout Session Evaluation Questions_final.docx Form and Instruction
3 Plenary Session Evaluation Questions_final.docx Plenary Session Evaluation Questions_final.docx Form and Instruction
4 Overall 2018 NRWC Evaluation_final.docx Overall 2018 NRWC Evaluation_final.docx Form and Instruction
Supporting Statement NRWC 2018_final.docx Supporting Statment A IC Document

Information Collection (IC) Details

IC Title:	2018 National Ryan White Conference on HIV Care & Treatment Evaluation	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Ryan White 2018 Session Evaluation 9.18.2018 FINAL2.pdf	Ryan White 2018 Session Evaluation 9.18.2018 FINAL2.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	2	Breakout Session Evaluation Questions_final.docx	Breakout Session Evaluation Questions_final.docx	Yes	Yes	Fillable Fileable
Form and Instruction	3	Plenary Session Evaluation Questions_final.docx	Plenary Session Evaluation Questions_final.docx	Yes	Yes	Fillable Fileable
Form and Instruction	4	Overall 2018 NRWC Evaluation_final.docx	Overall 2018 NRWC Evaluation_final.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,125	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	18,761	18,761
Annual IC Time Burden (Hours)	526	526
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statment A	Supporting Statement NRWC 2018_final.docx	09/20/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.