Pilot Survey of the Applying CDC's Guidelines for Prescribing Opioids Online Training and Updated Post Course Evaluation

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Document Name Document Type
Form 3 Month Follow up Pilot Survey of the Applying CDC's Guidelines for Prescribing Opioids Online Training and Updated Post Course Evaluation Form and Instruction
3 Month Follow up 0920-20LD Att a_3 Month Follow up Survey.docx Form and Instruction
1050 Request_Serrvice Delivery.docx Request for Approval IC Document
Survey_ScreenShots_Jan2020.docx Survey Screenshot IC Document

Information Collection (IC) Details

IC Title:	Pilot Survey of the Applying CDC's Guidelines for Prescribing Opioids Online Training and Updated Post Course Evaluation	Agency IC Tracking Number:	0920-20LD

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
Form and Instruction	3 Month Follow up Survey	0920-20LD	Att a_3 Month Follow up Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	1050 Request_Serrvice Delivery.docx	03/06/2020
Survey Screenshot	Survey_ScreenShots_Jan2020.docx	03/06/2020

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