[NCHHSTP] National HIV Surveillance System (NHSS)

ICR 202408-0920-003

OMB: 0920-0573

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-0573 can be found here:

2025-09-02 - No material or nonsubstantive change to a currently approved collection
2025-01-06 - No material or nonsubstantive change to a currently approved collection

Forms and Documents

Document Name	Status
Adult HIV/AIDS Confidential Case Report Form and Instruction	Unchanged
Adult HIV/AIDS Confidential Case Report Form and Instruction	Unchanged
Case Report Updates Form and Instruction	Unchanged
Case Report Updates Form and Instruction	Unchanged
Pediatric HIV Confidential Case Report Form (with Perinatal HIV Exposure information) Form and Instruction	Unchanged
Pediatric HIV Confidential Case Report Form (with Perinatal HIV Exposure information) Form and Instruction	Unchanged
Cluster Close-out Report Form and Instruction	Unchanged
Cluster Close-out Report Form and Instruction	Unchanged
Cluster Follow-up Report Form and Instruction	Unchanged
Cluster Follow-up Report Form and Instruction	Unchanged
Initial Cluster Report Form and Instruction	Unchanged
Initial Cluster Report Form and Instruction	Unchanged
Form 0920-0573 Annual Reporting: Standards Evaluation Report (SER) Form and Instruction	Modified
Form 0920-0573 Annual Reporting: Standards Evaluation Report (SER) Form and Instruction	Modified
Laboratory Updates Form and Instruction	Unchanged
Laboratory Updates Form and Instruction	Unchanged
Case Report Evaluations Form and Instruction	Unchanged
Case Report Evaluations Form and Instruction	Unchanged
Justification Memo for Nonsubstantive Change Request_0920-0573_NHSS.docx Justification for No Material/Nonsubstantive Change	2024-08-05
Justification Memo for Nonsubstantive Change Request_0920-0573_NHSS.docx Justification for No Material/Nonsubstantive Change	2024-08-05
Att 1_ Table 1_Summary of Proposed Changes.docx Supplementary Document	2023-10-17
Att 1_ Table 1_Summary of Proposed Changes.docx Supplementary Document	2023-10-17
Justification for Nonmaterial.docx Justification for No Material/Nonsubstantive Change	2023-10-17
Justification for Nonmaterial.docx Justification for No Material/Nonsubstantive Change	2023-10-17
Att_10 Summary of Changes FINAL_08Feb22_SERv3_PWID _update_clean.pdf Supplementary Document	2022-09-08
Att_10 Summary of Changes FINAL_08Feb22_SERv3_PWID _update_clean.pdf Supplementary Document	2022-09-08
Att_9_Project Determination.pdf Supplementary Document	2022-09-08
Att_9_Project Determination.pdf Supplementary Document	2022-09-08
Att_8_Data Security and Confidentiality Guidelines.pdf Supplementary Document	2022-09-08
Att_8_Data Security and Confidentiality Guidelines.pdf Supplementary Document	2022-09-08
Att_7(b) NHSS_ Complete AoC_Final updated 102621 per amendment_CSpacket.pdf Supplementary Document	2022-09-08
Att_7(b) NHSS_ Complete AoC_Final updated 102621 per amendment_CSpacket.pdf Supplementary Document	2022-09-08
Att_7(a) NHSS_ AoC Statement_FinalOct2019.pdf Supplementary Document	2022-09-08
Att_7(a) NHSS_ AoC Statement_FinalOct2019.pdf Supplementary Document	2022-09-08
Att_6(b) ATO.pdf Supplementary Document	2022-09-08
Att_6(b) ATO.pdf Supplementary Document	2022-09-08
Att_6(a) PIA.pdf Supplementary Document	2022-09-08
Att_6(a) PIA.pdf Supplementary Document	2022-09-08
Att_5 cdc-hiv-surveillance-report-2020-updated-vol-33.pdf Supplementary Document	2022-09-08
Att_5 cdc-hiv-surveillance-report-2020-updated-vol-33.pdf Supplementary Document	2022-09-08
Att_4(f) Cluster Report Form Instructions updated 11052021_share.pdf Supplementary Document	2022-09-08
Att_4(f) Cluster Report Form Instructions updated 11052021_share.pdf Supplementary Document	2022-09-08
Att_4(e) DETECTING HIV TRANSMISSION CLUSTERS 2022 v1 (1).pdf Supplementary Document	2022-09-08
Att_4(e) DETECTING HIV TRANSMISSION CLUSTERS 2022 v1 (1).pdf Supplementary Document	2022-09-08
Att_4(d) D2C-Monitoring-and-Evaluation-Guidance _Jun21fin_508C_8.30.pdf Supplementary Document	2022-09-08
Att_4(d) D2C-Monitoring-and-Evaluation-Guidance _Jun21fin_508C_8.30.pdf Supplementary Document	2022-09-08
Att_4(c) DUPLICATE REVIEW 2022 v1.pdf Supplementary Document	2022-09-08
Att_4(c) DUPLICATE REVIEW 2022 v1.pdf Supplementary Document	2022-09-08
Att_4(b) PEDIATRIC HIV CASE REPORT FORM 2023 v2_PWID edit_clean.pdf Supplementary Document	2022-09-08
Att_4(b) PEDIATRIC HIV CASE REPORT FORM 2023 v2_PWID edit_clean.pdf Supplementary Document	2022-09-08
Att_4(a) ADULT HIV CONFIDENTIAL CASE REPORT FORM 2023 v2.pdf Supplementary Document	2022-09-08
Att_4(a) ADULT HIV CONFIDENTIAL CASE REPORT FORM 2023 v2.pdf Supplementary Document	2022-09-08
Att_3(c) NHSS_dataelements_OMB_BG_KB_Clean_PWID edit_clean.pdf Supplementary Document	2022-09-08
Att_3(c) NHSS_dataelements_OMB_BG_KB_Clean_PWID edit_clean.pdf Supplementary Document	2022-09-08
Att_2(a) 60 Day FRN pub 4 -1-2022.pdf Supplementary Document	2022-09-07
Att_2(a) 60 Day FRN pub 4 -1-2022.pdf Supplementary Document	2022-09-07
Att_1_ Authorizing Legislation.pdf Supplementary Document	2022-09-07
Att_1_ Authorizing Legislation.pdf Supplementary Document	2022-09-07
SSB_08Aug22_clean.docx Supporting Statement B	2022-09-07
SSB_08Aug22_clean.docx Supporting Statement B	2022-09-07
SSA_NHSS_31AUG22_clean.docx Supporting Statement A	2022-09-07
SSA_NHSS_31AUG22_clean.docx Supporting Statement A	2022-09-07

IC Document Collections

IC ID	Document Title	Status
7028	Adult HIV/AIDS Confidential Case Report Form and Instruction	Unchanged
7028	Adult HIV/AIDS Confidential Case Report Form and Instruction	Unchanged
46032	Case Report Updates Form and Instruction	Unchanged
46032	Case Report Updates Form and Instruction	Unchanged
46030	Pediatric HIV Confidential Case Report Form (with Perinatal HIV Exposure information) Form and Instruction	Unchanged
46030	Pediatric HIV Confidential Case Report Form (with Perinatal HIV Exposure information) Form and Instruction	Unchanged
236513	Data De-duplication Activities Other-Technical Guidance for HIV Surveillance Programs: Duplicat	Unchanged
236512	Cluster Close-out Report Form and Instruction	Unchanged
236512	Cluster Close-out Report Form and Instruction	Unchanged
236511	Cluster Follow-up Report Form and Instruction	Unchanged
236511	Cluster Follow-up Report Form and Instruction	Unchanged
236510	Initial Cluster Report Form and Instruction	Unchanged
236510	Initial Cluster Report Form and Instruction	Unchanged
236509	Investigation Reporting and Evaluation Other-Data to Care Reporting Guidance for PS18-1802 and PS20-201	Unchanged
220109	Annual Reporting: Standards Evaluation Report (SER) Form and Instruction	Modified
220109	Annual Reporting: Standards Evaluation Report (SER) Form and Instruction	Modified
205249	Laboratory Updates Form and Instruction	Unchanged
205249	Laboratory Updates Form and Instruction	Unchanged
205248	Case Report Evaluations Form and Instruction	Unchanged
205248	Case Report Evaluations Form and Instruction	Unchanged

ICR Details