Information Collection Request

Notification of Intent to Use Schedule III, IV, or V Opioid Drugs for the Maintenance and Detoxification Treatment of Opiate Addiction

ICR 201607-0930-001 · OMB 0930-0234 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Patient Notice Patient Notice Form and Instruction New Available
Form Request for Patien Request for patient Limit Increase Form and Instruction New Available
Attachment A - DATA 2000.pdf Supplementary Document Uploaded 2016-07-12 Available
Supporting Statment for Bup Rule 8.1.16.doc Supporting Statement A Uploaded 2016-08-02 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
7645 Notification of Intent Instruction Modified
222817 Request for a Temporary Patient Increase Patient Increase for an Emergency Instruction New
222816 Patient Notice Form and Instruction New
222815 Renewal Request for a Patient Limit Increase Instruction New
222813 Diversion Control Plan Instruction New
222812 Request for patient Limit Increase Form and Instruction New
222811 Notice to Treat up to 100 Patients Instruction New
222810 Notification to Prescribe Immediately Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2019 36 Months From Approved 07/31/2018
3,147 0 2,050
701 0 149
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,147 2,050 0 1,097 0 0
Annual Time Burden (Hours) 701 149 0 552 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No