Information Collection

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

IC 240490 under ICR 201902-0920-022 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.