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Federal forms, ICRs, and supporting documents

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Rapid Interviews and Survey of Patients Being Treated with Ambien or Lunesta or their Health Care Professionals

IC 213536 under ICR 201404-0910-010 · OMB 0910-0500.

Documents and Forms
Document Name
Document Type
Other-Interview Script
Other-Interview Script
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Rapid Interviews and Survey of Patients Being Treated with Ambien or Lunesta or their Health Care Professionals CDER
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Interview Script APPENDIX I INTERVIEW SCRIPT FOR PATIENTS AND CONSUMERS 10-21-14.doc No   Paper Only
Other-Interview Script APPENDIX II INTERVIEW SCRIPT FOR HEALTHCARE PROVIDERS AND SUBSCRIBERS 10-21-14.doc No   Paper Only

Health Public Health Monitoring

 

50 0
   
Individuals or Households
 
   0 %

  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 50 0 0 0
Annual IC Time Burden (Hours) 25 0 25 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Rapid Response Survey 0500 OMB JUSTIFICATION MEMO 10-21-14.doc 10/21/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.