Information Collection

Assess Perception and Use of CDC Guideline for Prescribing Opioids for Chronic Pain

IC 228955 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⚠️ Notice: This information collection may be referencing outdated material.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
Attachment 1_Invitation to Survey Guideline POCP_Oct 2017.docx	Other-Invitation letter
Attachment 3_Follow Up Interviews_Guideline POCP_Oct 2017.docx	Other-Interview Guide
CDC Prescription Opioid Physician Survey Attachment 2_Survey Screenshots CDC Guideline POCP.PDF	Form
Project Description CDC Guideline POCP_Oct 2017_EF_RM.docx Project Description	IC Document
HMTSExpeditedReviewForm.pdf HTMS Review Form	IC Document

IC Title:

Assess Perception and Use of CDC Guideline for Prescribing Opioids for Chronic Pain

Agency IC Tracking Number:

0920-0572-18EX

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Invitation letter			Attachment 1_Invitation to Survey Guideline POCP_Oct 2017.docx	Yes	Yes	Fillable Fileable
Form	none	CDC Prescription Opioid Physician Survey	Attachment 2_Survey Screenshots CDC Guideline POCP.PDF	Yes	Yes	Fillable Fileable
Other-Interview Guide			Attachment 3_Follow Up Interviews_Guideline POCP_Oct 2017.docx	Yes	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,143

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	1,143	1,143
Annual IC Time Burden (Hours)	169	169
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Project Description	Project Description CDC Guideline POCP_Oct 2017_EF_RM.docx	11/08/2017
HTMS Review Form	HMTSExpeditedReviewForm.pdf	11/08/2017

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