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Medical Review Officer
Mandatory Guidelines for Federal Workplace Drug Testing Programs
OMB: 0930-0158
IC ID: 193835
OMB.report
HHS/SAMHSA
OMB 0930-0158
ICR 202111-0930-002
IC 193835
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0158 can be found here:
2023-03-22 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Same as Donor Form.docx
Instruction
Same as Donor Form.docx
Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Medical Review Officer
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
Same as Donor Form.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
6,726,610
Number of Respondents for Small Entity:
0
Affected Public:
Federal Government
Percentage of Respondents Reporting Electronically:
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
6,726,610
0
0
0
0
6,726,610
Annual IC Time Burden (Hours)
336,331
0
0
0
0
336,331
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.