Aim 2a Cohort Exit Interview (English/Spanish)

[NCHHSTP] _Expanding PrEP in Communities of Color (EPICC) (24BY)

OMB: 0920-1423

IC ID: 263131

Information Collection (IC) Details

View Information Collection (IC)

Aim 2a Cohort Exit Interview (English/Spanish) 0920-22GA
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-22GA Att 4m_Aim2a Cohort Exit Interview English Att_4m_Aim2aCohortExitInterviewEnglish[1].docx Yes Yes Fillable Fileable
Form and Instruction 0920-22GA Att 4m_Aim2aCohortExitInterviewSpanish Att_4m_Aim2aCohortExitInterviewSpanish[1].docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

15 0
   
Individuals or Households
 
   0 %

  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 15 0 0 0 0 15
Annual IC Time Burden (Hours) 15 0 0 0 0 15
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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