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

CDC and ATSDR Health Message Testing System

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.