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Completes, Main Study
Comparative Price Information in Direct-to-Consumer and Professional Prescription Drug Advertisements
OMB: 0910-0791
IC ID: 215729
OMB.report
HHS/FDA
OMB 0910-0791
ICR 201510-0910-007
IC 215729
( )
Documents and Forms
Document Name
Document Type
Provider Questionnaire Revised 0791 10-14-2015.docx
Other-Provider Survey
CONSENT FORM CONSUMER 3-17-25.doc
Other-Consent Form Consumer
CONSENT FORM PROVIDERS 3-17-15.doc
Other-Consent Form Providers
Consumer Questionnaire Revised 0791 10-14-2015.docx
Other-Consumer Survey
Endocrinology Invite_Main Study.docx
Other-Endocrinology Invite Main Stud
PCP Invite Main Study.docx
Other-PCP Invite Main Study
PATIENT EMAIL INVITE 3-17-15.docx
Other-Patient Email Invite
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Completes, Main Study
Agency IC Tracking Number:
CDER
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Provider Survey
Provider Questionnaire Revised 0791 10-14-2015.docx
Yes
Yes
Fillable Fileable Signable
Other-Consent Form Consumer
CONSENT FORM CONSUMER 3-17-25.doc
Yes
Yes
Fillable Fileable Signable
Other-Consent Form Providers
CONSENT FORM PROVIDERS 3-17-15.doc
Yes
Yes
Fillable Fileable Signable
Other-Consumer Survey
Consumer Questionnaire Revised 0791 10-14-2015.docx
Yes
Yes
Fillable Fileable Signable
Other-Endocrinology Invite Main Study
Endocrinology Invite_Main Study.docx
Yes
Yes
Printable Only
Other-PCP Invite Main Study
PCP Invite Main Study.docx
Yes
Yes
Printable Only
Other-Patient Email Invite
PATIENT EMAIL INVITE 3-17-15.docx
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,940
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
2,940
0
0
0
0
2,940
Annual IC Time Burden (Hours)
1,470
0
0
0
0
1,470
Annual IC Cost Burden (Dollars)
0
0
0
0
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.