Pharmacy SOPS Database Data Use Agreement

Pharmacy Survey on Patient Safety Culture Database

OMB: 0935-0218

IC ID: 211068

Information Collection (IC) Details

View Information Collection (IC)

Pharmacy SOPS Database Data Use Agreement
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2 Attachment B: Pharmacy Database Data Use Agreement Attachment B - Pharmacy DUA - 02-22-2017_updated 6-13-17_clean.docx Yes Yes Fillable Printable

Health Health Care Services

 

100 0
   
Private Sector Businesses or other for-profits
 
   0 %

  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 100 0 -50 0 0 150
Annual IC Time Burden (Hours) 5 0 -3 0 0 8
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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