Information Collection

Interim Assessment of Messages for the Prescription Drug Overdose Prevention, Awareness, and Knowledge Building Campaign

IC 226286 under ICR 201502-0920-001 · OMB 0920-0572.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Screen Shots of the Prescription Drug Overdose Survey Interim Assessment of Messages for the Prescription Drug Overdose Prevention, Awareness, and Knowledge Building Campaign	Form
Att A Instrument PDO.docx	Other-Overview of Questions in the P
Screen Shots of the Prescription Drug Overdose Survey Att B PDO PCS Screen Shots 0572.pdf	Form
Att E1 PDO_Radio_AnnMarie_12.16.16_ForDistribution.mp3 Radio Ad (Ann Marie)	IC Document
Att E2 PDO_Radio_Judy_12.15.16_ForDistribution.mp3 Radio Ad (Judy)	IC Document
Att E3 PDO_Radio_Mike_12.16.16_ForDistribution.mp3 Radio Ad (Mike)	IC Document
Att E4 PDO_Radio_Noah_12.16.16_ForDistribution.mp3 Radio Ad (Noah)	IC Document
Att E5 PDO_Radio_Tamera_12.15.16_ForDistribution.mp3 Radio Ad (Tamera)	IC Document
Att E6 PDO Billboard.png PDO Billboard Ad	IC Document
Att E7 PDO Web Banner.jpg PDO Web Banner	IC Document
Att E8 PDO Web Banner_ANIMATED.gif PDO Animated Web Banner	IC Document
1. PDO_HMTSExpeditedReviewForm.pdf HMTS Review Form for the PDO Interim Assessment	IC Document
Att D PDO Project Description.docx Project Description	IC Document
Att C. Privacy Act.pdf Privacy Act Determination	IC Document

IC Title:

Interim Assessment of Messages for the Prescription Drug Overdose Prevention, Awareness, and Knowledge Building Campaign

Agency IC Tracking Number:

0920-17ACG

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	N/A				Yes	Yes	Fillable Fileable
Other-Overview of Questions in the PDO Survey					No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,430

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,430	1,430
Annual IC Time Burden (Hours)	358	358
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Radio Ad (Ann Marie)		04/05/2017
Radio Ad (Judy)		04/05/2017
Radio Ad (Mike)		04/05/2017
Radio Ad (Noah)		04/05/2017
Radio Ad (Tamera)		04/05/2017
PDO Billboard Ad		04/05/2017
PDO Web Banner		04/05/2017
PDO Animated Web Banner		04/05/2017
HMTS Review Form for the PDO Interim Assessment		04/05/2017
Project Description		04/05/2017
Privacy Act Determination		04/05/2017

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

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