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⚠️ Notice: This information collection may be referencing outdated material.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
Stakeholder Engagement and Feedback -Management of Acute and Chronic Pain Form and Instruction
Stakehold Engagement Att 1. StakeholderEngagementProtocol_3-17-2020.docx Form and Instruction
1050RequestTemplateServiceDelivery_3-17-2020.docx Request for Approval IC Document
NOA_Stakeholder Enganement.pdf NOA from previous submission IC Document
Att 2. Applicability of Privacy.pdf Privacy determination IC Document

Information Collection (IC) Details

IC Title:	Stakeholder Engagement and Feedback -Management of Acute and Chronic Pain	Agency IC Tracking Number:	0920-1050-20LU

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	none	Stakehold Engagement	Att 1. StakeholderEngagementProtocol_3-17-2020.docx		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	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	200	200
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	1050RequestTemplateServiceDelivery_3-17-2020.docx	03/23/2020
NOA from previous submission	NOA_Stakeholder Enganement.pdf	03/23/2020
Privacy determination	Att 2. Applicability of Privacy.pdf	03/23/2020

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