Information Collection

Pharmacist Survey Completes

IC 216608 under ICR 201505-0910-003 · OMB 0910-0801.

Documents and Forms

Document Name Document Type
Appendix 1. National Survey of Pharmacists About Pill Appearance.doc Other-National Survey of Pharmacists
Appendix 4. Pharmacist Survey Alert Letter Example.docx Other-Pharmacist Survey Alert Letter
Appendix 5. Pharmacist Survey Cover Letter.doc Other-Pharmacist Survey Cover Letter
Appendix 8. Pharmacist Survey Intro Online Survey.docx Other-Pharmacist Survey Intro Online
Appendix 6. Pharmacist Survey Reminder Letter 1.docx Other-Pharmacist Survey Reminder Let
Appendix 7. Pharmacist Survey Reminder Letter 2.doc Other-Pharmacist Survey Reminder Let

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Pharmacist Survey Completes	Agency IC Tracking Number:	CDER

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-National Survey of Pharmacists About Pill Appearance	Appendix 1. National Survey of Pharmacists About Pill Appearance.doc	Yes	Yes	Fillable Fileable Signable
Other-Pharmacist Survey Alert Letter	Appendix 4. Pharmacist Survey Alert Letter Example.docx	Yes	Yes	Fillable Fileable Signable
Other-Pharmacist Survey Cover Letter	Appendix 5. Pharmacist Survey Cover Letter.doc	Yes	Yes	Fillable Fileable Signable
Other-Pharmacist Survey Intro Online Survey	Appendix 8. Pharmacist Survey Intro Online Survey.docx	Yes	Yes	Fillable Fileable Signable
Other-Pharmacist Survey Reminder Letter 1	Appendix 6. Pharmacist Survey Reminder Letter 1.docx	Yes	Yes	Fillable Fileable Signable
Other-Pharmacist Survey Reminder Letter 2	Appendix 7. Pharmacist Survey Reminder Letter 2.doc	Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 20 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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