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Federal forms, ICRs, and supporting documents

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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.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

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Pilot Survey of the Applying CDC's Guidelines for Prescribing Opioids Online Training and Updated Post Course Evaluation 0920-20LD
 
New
 
Voluntary
 

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

Health Public Health Monitoring

 

100 0
   
State, Local, and Tribal Governments
 
   0 %

  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 100 0 100 0 0 0
Annual IC Time Burden (Hours) 17 0 17 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.