Provider Baseline Survey

HIV Knowledge, Beliefs, Attitudes, and Practices of Providers in the Southeast

OMB: 0920-1160

IC ID: 222568

Information Collection (IC) Details

View Information Collection (IC)

Provider Baseline Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Baseline survey Att3a_Baseline Screener-Survey_clean.docx Yes Yes Fillable Fileable
Form none Baseline Screener and Survey Screenshots Att9a_Screenshots_BaselineScreenerSurvey_clean.docx Yes Yes Fillable Fileable

Health Health Care Services

 

1,827 0
   
Private Sector Businesses or other for-profits
 
   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 1,827 0 1,827 0 0 0
Annual IC Time Burden (Hours) 914 0 914 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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