Information Collection Request

[NCHHSTP] TRANSCEND: Transgender Status-neutral Community-to-clinic Models to End the HIV Epidemic

ICR 202305-0920-002 · OMB 0920-1410 · Received in OIRA

Forms and Documents

Document Name	Status
Client Satisfaction Survey (data manager) Form and Instruction	New
Client Satisfaction Survey (client) Form and Instruction	New
Client Intake Form (client) Form and Instruction	New
Client Intake Form (data manager) Form and Instruction	New
Att4_PD_TRANSCEND_combined.pdf Supplementary Document	2023-05-25
Att2 60 Day FRN Pub 11-16-2022.pdf Supplementary Document	2023-05-25
Att 1_Authorizing Legislation.docx Supplementary Document	2023-05-25
Supporting Statement B.docx Supporting Statement B	2023-05-25
Supporting Statement A.docx Supporting Statement A	2023-05-25

IC Document Collections

IC ID	Document Title	Status
260399	Client Satisfaction Survey (data manager) Form and Instruction	New
260398	Client Satisfaction Survey (client) Form and Instruction	New
260397	Client Intake Form (client) Form and Instruction	New
260396	Client Intake Form (data manager) Form and Instruction	New
260395	Electronic Health Record Data Other-Specification of Data Elements for Electronic Transfer	New

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CDC
OMB Control No	0920-1410
Type of Information Collection	New collection (Request for a new OMB Control Number)
Agency Tracking No	0920-23AP
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31