HIV-negative Patients Seeking HIV Testing - Study Visit Survey

[NCHHSTP] The GAIN (Greater Access and Impact with NAT) Study: Improving HIV Diagnosis, Linkage to Care, and Prevention Services with HIV Point-of-Care Nucleic Acid Tests (NATs)

OMB: 0920-1357

IC ID: 247950

Documents and Forms
Document Name
Document Type
Form
Form
Form
Form
Form
Information Collection (IC) Details

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HIV-negative Patients Seeking HIV Testing - Study Visit Survey 0920-1357-24AQ
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-1357 Study Visit Survey (SCREENSHOTS) Att 11_GAIN study visit survey_screenshots_11-18-21.pdf Yes Yes Printable Only
Form 0920-1357 GAIN Study Visit Survey - Revised 09SEP2022 (SCREENSHOTS) Att 11_GAIN study visit survey_screenshots_changes accepted_082922.docx NA Yes Yes Printable Only

Health Health Care Services

 

50 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 50 0 0 0 0 50
Annual IC Time Burden (Hours) 13 0 0 0 0 13
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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