Assessment of Physician Applicants' Experiences with FDA's Expanded Access and Compassionate Use Programs

Customer/Partner Service Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0360 can be found here:

Documents and Forms

Document Name Document Type
Physician Survey.pdf Other-Survey
Consent Form.docx Other-Consent Form
0360 OMB Approval Memo EA and CU Programs.doc OMB approval memorandum IC Document

Information Collection (IC) Details

IC Title:	Assessment of Physician Applicants' Experiences with FDA's Expanded Access and Compassionate Use Programs	Agency IC Tracking Number:	OC

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			Physician Survey.pdf		Yes	Yes	Fillable Fileable
Other-Consent Form			Consent Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB approval memorandum	0360 OMB Approval Memo EA and CU Programs.doc	11/27/2017

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