Information Collection

Pilot Testing in Opioid Treatment Programs (OTPs) of Modular Survey with OTP-Speicfic Questions

IC 191756 under ICR 200710-0930-001 · OMB 0930-0197.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0197 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Modular Survey - O Pilot Testing in Opioid Treatment Programs (OTPs) of Modular Survey with OTP-Speicfic Questions	Form and Instruction
Modular Survey - O Modular Survey - OTP Questions Attachment 1 - Modular Survey Instrument with OTP Questions 12-18-09 ag.doc	Form and Instruction
OTP Modular Survey OMB 12-18-09 ag.doc Justification	IC Document
OMBTransLet10-2009.wpd Letter	IC Document

IC Title:

Pilot Testing in Opioid Treatment Programs (OTPs) of Modular Survey with OTP-Speicfic Questions

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Modular Survey - OTP Questions	Modular Survey - OTP Questions	Attachment 1 - Modular Survey Instrument with OTP Questions 12-18-09 ag.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	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	1,200	0	0	0	0	0
Annual IC Time Burden (Hours)	300	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification	OTP Modular Survey OMB 12-18-09 ag.doc	01/07/2010
Letter	OMBTransLet10-2009.wpd	01/07/2010

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