Request for patient Limit Increase

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

OMB: 0930-0234

IC ID: 222812

Information Collection (IC) Details

View Information Collection (IC)

Request for patient Limit Increase
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Request for Patient Limit Increase Request for Patient Limit Increase Attachment B - Request for Patient Limit Increase.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

517 0
   
State, Local, and Tribal Governments
 
   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 517 0 517 0 0 0
Annual IC Time Burden (Hours) 259 0 259 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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