Information Collection

Survey of Primary Care Clinicians about Opioid Use among Older Adults

IC 243373 under ICR 202008-0935-001 · OMB 0935-0258.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0258 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Survey of Primary Care Clinicians about Opioid Use among Older Adults	Form and Instruction
1 Survey of Primary Care Clinicians about Opioid Use among Attachment A. Primary Care Clinician Survey 4.1.20.docx	Form and Instruction
1 Survey of Primary Care Clinicians about Opioid Use among Attachment A. Primary Care Clinician Survey 4.1.20.docx	Form and Instruction

IC Title:

Survey of Primary Care Clinicians about Opioid Use among Older Adults

Agency IC Tracking Number:

Is this a Common Form? No

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	1	Survey of Primary Care Clinicians about Opioid Use among Older Adults	Attachment A. Primary Care Clinician Survey 4.1.20.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,500

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	1,500	1,500
Annual IC Time Burden (Hours)	375	375
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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