OMB
.report
Search
C4P Provider DCE Survey
Preferences for Longer-Acting Preexposure Prophylaxis (PrEP) Methods Among Persons in US Populations at Highest Need: A Discrete Choice Experiment
OMB: 0920-1400
IC ID: 256139
OMB.report
HHS/CDC
OMB 0920-1400
ICR 202209-0920-019
IC 256139
( )
Documents and Forms
Document Name
Document Type
Form 0920
C4P Provider DCE Survey
Form and Instruction
0920 C4P Provider DCE Survey
Att 8 Provider DCE Survey.docx
survey.rti.org/SE/1/ProviderSurveyDev
Form and Instruction
0920 C4P Provider DCE Survey
Att 8 Provider DCE Survey.docx
survey.rti.org/SE/1/ProviderSurveyDev
Form and Instruction
Att 8a Provider DCE Survey Screenshots.docx
C4P Provider DCE Survey Screenshots
IC Document
Att 8a Provider DCE Survey Screenshots.docx
C4P Provider DCE Survey Screenshots
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
C4P Provider DCE Survey
Agency IC Tracking Number:
0920-22CX
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
0920
C4P Provider DCE Survey
Att 8 Provider DCE Survey.docx
https://survey.rti.org/SE/1/ProviderSurveyDev
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
230
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
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
230
0
230
0
0
0
Annual IC Time Burden (Hours)
77
0
77
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
C4P Provider DCE Survey Screenshots
Att 8a Provider DCE Survey Screenshots.docx
09/26/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.