Information Collection

Studies to Enhance FDA Communications Addressing Opioids and Other Potentially Addictive Pain Medications

IC 228656 under ICR 201701-0910-014 · OMB 0910-0695.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0695 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Consumer opioid survey.doc	Other-Consumer survey
Email invitations for Consumers.docx	Other-Email invitation for Consumers
Intro and Screening for Consumers.docx	Other-Intro for Consumers
Informed consent form for Consumers.docx	Other-Consent Form for Consumers
HCP opioid survey.docx	Other-HCP Survey
Email invitations for HCPs.docx	Other-Email invitation for HCPs
Intro and Screening for HCPs.docx	Other-Intro for HCPs
Informed consent form for HCPs.docx	Other-Consent Form for HCPs
0695 OMB Approval Memo Opioid and Other Meds Study.doc OMB approval memo	IC Document

IC Title:

Studies to Enhance FDA Communications Addressing Opioids and Other Potentially Addictive Pain Medications

Agency IC Tracking Number:

CDER

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Consumer survey	Consumer opioid survey.doc	Yes	Yes	Fillable Fileable
Other-Email invitation for Consumers	Email invitations for Consumers.docx	Yes	Yes	Paper Only
Other-Intro for Consumers	Intro and Screening for Consumers.docx	Yes	Yes	Paper Only
Other-Consent Form for Consumers	Informed consent form for Consumers.docx	Yes	Yes	Fillable Fileable
Other-HCP Survey	HCP opioid survey.docx	Yes	Yes	Fillable Fileable
Other-Email invitation for HCPs	Email invitations for HCPs.docx	Yes	Yes	Paper Only
Other-Intro for HCPs	Intro and Screening for HCPs.docx	Yes	Yes	Paper Only
Other-Consent Form for HCPs	Informed consent form for HCPs.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,365

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,365	1,365
Annual IC Time Burden (Hours)	744	744
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB approval memo	0695 OMB Approval Memo Opioid and Other Meds Study.doc	10/20/2017

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