Information Collection

Healthcare Professional Interviews: Risk Processing for Newly Promoted Prescription Drugs (CDER)

IC 239426 under ICR 201712-0910-001 · OMB 0910-0695.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Screener.docx Other-Screener
Informed Consent Form - nonMedStar.docx Other-Informed Consent - nonMedStar
Informed Consent Form - NP and PA.docx Other-Informed Consent Form - NP and
Informed Consent Form - PCP.docx Other-Informed Consent Form - PCP
Informed Consent Form - Specialist.docx Other-Informed Consent Form - Specia
Recruitment Flyer - MedStar.docx Other-Recruitment Flyer - MedStar
Recruitment Flyer nonMedStar.docx Other-Recruitment Flyer - nonMedStar
0695 OMB Approval Memo 2020.docx
OMB approval memo
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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-Screener Screener.docx No   Paper Only
Other-Informed Consent - nonMedStar Informed Consent Form - nonMedStar.docx No   Paper Only
Other-Informed Consent Form - NP and PA Informed Consent Form - NP and PA.docx No   Paper Only
Other-Informed Consent Form - PCP Informed Consent Form - PCP.docx No   Paper Only
Other-Informed Consent Form - Specialist Informed Consent Form - Specialist.docx No   Paper Only
Other-Recruitment Flyer - MedStar Recruitment Flyer - MedStar.docx No   Paper Only
Other-Recruitment Flyer - nonMedStar Recruitment Flyer nonMedStar.docx No   Paper Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 225 0 225 0 0 0
Annual IC Time Burden (Hours) 0 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
OMB approval memo 0695 OMB Approval Memo 2020.docx 01/23/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.