Initial Participant Screening for Eligibility

Mobile Messaging Intervention to Present New HIV Prevention Options for Men Who have Sex with Men (MSM): Randomized Controlled Trial

OMB: 0920-1209

IC ID: 226271

Information Collection (IC) Details

View Information Collection (IC)

Initial Participant Screening for Eligibility
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form N/A Participant Screening Att 4a_Participant Screening Form_02-15-2017.docx Yes Yes Fillable Fileable
Form N/A Screenshots of the Screening Form Att 4g_M-Cubed P2 Screening Form Screenshots.pdf Yes Yes Fillable Fileable

Health Illness Prevention

 

1,693 0
   
Individuals or Households
 
   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 1,693 0 0 0 0 1,693
Annual IC Time Burden (Hours) 113 0 0 0 0 113
Annual IC Cost Burden (Dollars) 2,622 0 0 0 0 2,622

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