Information Collection

Opioid Care Coordination Consultation Meetings Feedback

IC 234882 under ICR 201703-0990-003 · OMB 0990-0459.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0459 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-0459 Fast Track Clearance-CCM Meeting Feedback Form.docx	Other-survey
0990-0459 MEMO_FastTrack Generic Clearance Submission-CCM Meeting Feedback.docx Memo	IC Document

IC Title:

Opioid Care Coordination Consultation Meetings Feedback

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey			0990-0459 Fast Track Clearance-CCM Meeting Feedback Form.docx		No		Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 96

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	96	96
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Memo	0990-0459 MEMO_FastTrack Generic Clearance Submission-CCM Meeting Feedback.docx	02/08/2019

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