Qualifying Other Practitioner

Notification of Intent to Use Schedule III, IV, or V Opioid Drugs for the Maintenance and Detoxification Treatment of Opiate Addiction

OMB: 0930-0234

IC ID: 223711

Information Collection (IC) Details

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Qualifying Other Practitioner
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Qualifying Other Pratitioner Qualifying Other Pratitioner Attachment B NOI Qualifying Other Practitioner NP and PA 30 and 100 9.16.2019.doc Yes Yes Fillable Fileable

Health Public Health Monitoring

 

3,176 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,176 0 1,826 0 0 1,350
Annual IC Time Burden (Hours) 210 0 -3,840 0 0 4,050
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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