Information Collection

Feedback on the use of the CDC Guideline for Prescribing Opioids for Chronic Pain.

IC 241950 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⚠️ Notice: This information collection may be referencing outdated material.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
Form 0920-20OP Feedback on the use of the CDC Guideline for Prescribing Opioids for Chronic Pain.	Form and Instruction
0920-20OP Online Feedback Opioid Guides Att.1. Online Feedback OpioidGuides.docx	Form and Instruction
Att. 1a. Online Feedback_Screen Capture.docx Online Feedback Screen Capture	IC Document
1050 Request for Service Delivery_Updated_OpiodGuides_4.29.20.v2.docx Request for Service Delivery	IC Document
Att. 2. Privacy Applicability.pdf Privacy	IC Document

IC Title:

Feedback on the use of the CDC Guideline for Prescribing Opioids for Chronic Pain.

Agency IC Tracking Number:

0920-20OP

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	0920-20OP	Online Feedback Opioid Guides	Att.1. Online Feedback OpioidGuides.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Online Feedback Screen Capture	Att. 1a. Online Feedback_Screen Capture.docx	05/22/2020
Request for Service Delivery	1050 Request for Service Delivery_Updated_OpiodGuides_4.29.20.v2.docx	05/22/2020
Privacy	Att. 2. Privacy Applicability.pdf	05/22/2020

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