Information Collection

Stakeholder Engagement and Feedback -Management of Acute and Chronic Pain

IC 240503 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⚠️ Notice: This information collection may be referencing outdated material.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
Att. 1 Individual conversations Protocol (003).docx	Instruction
Att. 2 Stakeholder Session Protocol (003).docx	Other-WORD
1050 RequestTemplateServiceDelivery.docx Request for Approval	IC Document
Att 3. Applicability of Privacy.pdf Att 3_Privacy Determination	IC Document

IC Title:

Stakeholder Engagement and Feedback -Management of Acute and Chronic Pain

Agency IC Tracking Number:

0920-1050-20KR

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
Instruction			Att. 1 Individual conversations Protocol (003).docx		No		Paper Only
Other-WORD			Att. 2 Stakeholder Session Protocol (003).docx		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 360

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	360	360
Annual IC Time Burden (Hours)	660	660
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	1050 RequestTemplateServiceDelivery.docx	03/06/2020
Att 3_Privacy Determination	Att 3. Applicability of Privacy.pdf	03/06/2020

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