Information Collection

Individual Interview Study of Healthcare Provider Perceptions of Boxed Warnings

IC 230240 under ICR 201803-0910-011 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Participant Screener.docx	Other-Screener
Moderator Guide.docx	Other-Moderator Guide
Consent Form for Primary Care Providers.docx	Other-Consent Form for PCP
Consent Form for Specialists.docx	Other-Consent Form for Specialists
0695 OMB approval memo for HCP Perceptions of Boxed Warnings.docx OMB approval memo	IC Document

IC Title:

Individual Interview Study of Healthcare Provider Perceptions of Boxed Warnings

Agency IC Tracking Number:

CDER

IC Status: Unchanged

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-Screener	Participant Screener.docx	Yes	Yes	Fillable Fileable
Other-Moderator Guide	Moderator Guide.docx	No		Paper Only
Other-Consent Form for PCP	Consent Form for Primary Care Providers.docx	Yes	Yes	Fillable Fileable
Other-Consent Form for Specialists	Consent Form for Specialists.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	60	60
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 for HCP Perceptions of Boxed Warnings.docx	02/23/2018

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