Survey of "Health Care Providers' Responses to Medical Device Labeling Content

Survey of "Health Care Providers' Responses to Medical Device Labeling"

Documents and Forms

Document Name Document Type
Attachment B - Cover Letter.doc Other-Cover Letter
Telephone Script for Interviewer.doc Other-Telephone Script
Attachment A - Questionnaire and Confidentiality Assurance.docx Other-Survey
Attachment G - Label Version 3.pdf Attachment G - Label Version 3 IC Document
Attachment E - Label Version 1.pdf Attachment E - Label Version 1 IC Document
Attachment F - Label Version 2.pdf Attachment F - Label Version 2 IC Document
Device Label Survey screenshots.doc Device Label Survey screenshots IC Document
Attachment D - Label Version Table.doc Attachment D - Label Version Table IC Document

Information Collection (IC) Details

IC Title:	Survey of "Health Care Providers' Responses to Medical Device Labeling Content	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 21 CFR 801

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Telephone Script	Telephone Script for Interviewer.doc	No		Paper Only
Other-Survey	Attachment A - Questionnaire and Confidentiality Assurance.docx	Yes	Yes	Fillable Fileable Signable
Other-Cover Letter	Attachment B - Cover Letter.doc	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,248	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,248	1,248
Annual IC Time Burden (Hours)	324	324
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment G - Label Version 3	Attachment G - Label Version 3.pdf	03/01/2012
Attachment E - Label Version 1	Attachment E - Label Version 1.pdf	03/01/2012
Attachment F - Label Version 2	Attachment F - Label Version 2.pdf	03/01/2012
Device Label Survey screenshots	Device Label Survey screenshots.doc	03/01/2012
Attachment D - Label Version Table	Attachment D - Label Version Table.doc	07/02/2012

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