OMB control number

Integrating Community Pharmacists and Clinical Sites for Patient-Centered HIV Care

OMB 0920-1019 · HHS/CDC.

OMB 0920-1019

Latest Forms, Documents, and Supporting Material

Document Name
Project Staff Communication Form - medical providers Form
Pharmacy Cost Form Form
Clinic Staff Cost Form Form
Project Staff Communication Form - pharmacists Form
Key Informants Interview Form
Pharmacy Record Abstraction Form Form
Quarterly Patient Information Form Form
Initial Patient Information Form Form
Patient Demographic Information Form Form
Project Pharmacy Characteristics Form Form
Project Clinic Characteristics Form Form
Att 14_ChangestoICR.docx Supplementary Document
Att 9b_information form_spanish.docx Supplementary Document
Att 9a_information form.docx Supplementary Document
PS-13-1315-UNTHSC.IRB.Approval.Letter.and.Protocol-Summary.pdf Supplementary Document
Att2 60 Day FRN.pdf Supplementary Document
Att 1_Auth Legislation.pdf Supplementary Document
SS B_Clean.docx Supporting Statement B
SS A_Clean.docx Supporting Statement A
Project Staff Communication Form - medical providers Form
Pharmacy Cost Form Form
Clinic Staff Cost Form Form
Project Staff Communication Form - pharmacists Form
Key Informants Interview Form
Pharmacy Record Abstraction Form Form
Quarterly Patient Information Form Form
Initial Patient Information Form Form
Patient Demographic Information Form Form
Project Pharmacy Characteristics Form Form
Project Clinic Characteristics Form Form

All Historical Document Collections

201602-0920-007 Approved without change	Revision of a currently approved collection	2016-02-18
201509-0920-012 Approved without change	No material or nonsubstantive change to a currently approved collection	2015-10-06
201505-0920-005 Approved with change	Revision of a currently approved collection	2015-06-04
201406-0920-009 Approved without change	No material or nonsubstantive change to a currently approved collection	2014-06-23
201403-0920-016 Approved without change	New collection (Request for a new OMB Control Number)	2014-03-28