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Attachment D: Learning Collaborative Staff Interview
Identifying and Testing Strategies for Management of Opioid Use and Misuse in Older Adults in Primary Care Practices
OMB: 0935-0258
IC ID: 243377
OMB.report
HHS/AHRQ
OMB 0935-0258
ICR 202107-0935-002
IC 243377
( )
Documents and Forms
Document Name
Document Type
Form 4
Attachment D: Learning Collaborative Staff Interview
Form and Instruction
4 Attachment D: Learning Collaborative Staff Interview
Attachment D_Learning Collaborative Staff Interview_05-04-2020.docx
Form and Instruction
4 Attachment D: Learning Collaborative Staff Interview
Attachment D_Learning Collaborative Staff Interview_05-04-2020.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Attachment D: Learning Collaborative Staff Interview
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
Form and Instruction
4
Attachment D: Learning Collaborative Staff Interview
Attachment D_Learning Collaborative Staff Interview_05-04-2020.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
48
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
96
0
0
0
0
96
Annual IC Time Burden (Hours)
48
0
0
0
0
48
Annual IC Cost Burden (Dollars)
0
0
0
0
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.