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NMURx Express Survey to Evaluate Stimulant Abuse in the United States: Trajectories from Medical Use to Non-Medical Use (CDER)
Data To Support Social and Behavioral Research as Used by the Food and Drug Administration
OMB: 0910-0847
IC ID: 248266
OMB.report
HHS/FDA
OMB 0910-0847
ICR 202205-0910-005
IC 248266
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0847 can be found here:
2023-11-03 - No material or nonsubstantive change to a currently approved collection
2022-12-28 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Questionnaire.docx
Other-Questionnaire
Questionnaire.docx
Other-Questionnaire
Consent Form.docx
Other-Consent Form
Consent Form.docx
Other-Consent Form
Confidentiality Certificate.pdf
Other-Certification of Confidentiali
Confidentiality Certificate.pdf
Other-Certification of Confidentiali
0847 OMB Approval Memo - Evaluation of Stimulant Abuse in US 2021.docx
OMB Approval Memo
IC Document
0847 OMB Approval Memo - Evaluation of Stimulant Abuse in US 2021.docx
OMB Approval Memo
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NMURx Express Survey to Evaluate Stimulant Abuse in the United States: Trajectories from Medical Use to Non-Medical Use (CDER)
Agency IC Tracking Number:
CDER
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
Other-Questionnaire
Questionnaire.docx
Yes
Yes
Fillable Fileable
Other-Consent Form
Consent Form.docx
Yes
Yes
Fillable Fileable
Other-Certification of Confidentiality
Confidentiality Certificate.pdf
Yes
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,400
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
1,400
0
0
0
0
1,400
Annual IC Time Burden (Hours)
233
0
0
0
0
233
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Approval Memo
0847 OMB Approval Memo - Evaluation of Stimulant Abuse in US 2021.docx
07/08/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.