Stakeholder Engagement and Feedback -Management of Acute and Chronic Pain

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⚠️ Notice: This information collection may be referencing outdated material.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
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

Information Collection (IC) Details

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:

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 %

	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

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.