Information Collection

Stakeholder Engagement and Feedback -Management of Acute and Chronic Pain

IC 240802 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⚠️ Notice: This information collection may be referencing outdated material.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
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

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:

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.