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State Unintentional Drug Overdose Reporting System (SUDORS)
State Unintentional Drug Overdose Reporting System (SUDORS)
OMB: 0920-1128
IC ID: 220172
OMB.report
HHS/CDC
OMB 0920-1128
ICR 201602-0920-010
IC 220172
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1128 can be found here:
2022-09-14 - Revision of a currently approved collection
2019-10-29 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
State Unintentional Drug Overdose Reporting System (SUDORS)
Form
SUDORS - screenshots
Att E. SUDORS Screen Shots_ICRO.docx
Form
Att D. DataElements SUDORS.docx
SUDORS Data Elements
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
State Unintentional Drug Overdose Reporting System (SUDORS)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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
Form
none
SUDORS - screenshots
Att E. SUDORS Screen Shots_ICRO.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
16
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
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
14,016
0
14,016
0
0
0
Annual IC Time Burden (Hours)
7,008
0
7,008
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SUDORS Data Elements
Att D. DataElements SUDORS.docx
02/18/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.