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Harm Reduction Toolkit for Non-Prescription Syringe Sales in Community Pharmacies (Pre-Test)

IC 249319 under ICR 202107-0920-011 · OMB 0920-1364.

Documents and Forms
Document Name
Document Type
Form
Form
IC Document
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Harm Reduction Toolkit for Non-Prescription Syringe Sales in Community Pharmacies (Pre-Test) 02021DZ
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-21DZ Harm Reduction Toolkit for Non-Prescription Syringe Sales in Community Pharmacies (Pre-Test Survey) Attachment 6_Pre-test survey.docx Yes Yes Fillable Fileable

Health Health Care Services

 

60 0
   
Private Sector Not-for-profit institutions
 
   100 %

  Requested 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 60 0 60 0 0 0
Annual IC Time Burden (Hours) 30 0 30 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Pharmacy Staff NPSS Pre/Post Survey Attachment 7a_ Screenshots for Pre- and Post-test surveys.docx 09/14/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.