HCP Survey - Main Study

Healthcare Provider Perception of Boxed Warning Information Survey

Documents and Forms

Document Name Document Type
Appendix C - Estrogen Survey.docx Other-Survey Instrument
Appendix C - HCV Survey.docx Other-Survey Instrument

Information Collection (IC) Details

IC Title:	HCP Survey - Main Study	Agency IC Tracking Number:	CDER

Is this a Common Form? No		IC Status: Modified

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
Other-Survey Instrument			Appendix C - Estrogen Survey.docx		Yes	Yes	Fillable Fileable
Other-Survey Instrument			Appendix C - HCV Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,156	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,156	1,156
Annual IC Time Burden (Hours)	324	324
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.