Information Collection

Exploring Healthcare Providers' Practices, Perspectives, and Experiences Prescribing and Co-Prescribing Benzodiazepines and Opioids (CDER)

IC 249440 under ICR 202206-0910-015 · OMB 0910-0695.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0695 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix A - Focus Group Screener.docx	Other-Focus Group Screener
Appendix A - Focus Group Screener.docx	Other-Focus Group Screener
Appendix B - Interview Screener.docx	Other-Interview Screener
Appendix B - Interview Screener.docx	Other-Interview Screener
Appendix C - Recruitment Outreach for FGs and IDIs.docx	Other-Recruitment Outreach for FGs a
Appendix C - Recruitment Outreach for FGs and IDIs.docx	Other-Recruitment Outreach for FGs a
Appendix D - Focus Group Moderator Guide.docx	Other-Moderator Guide for Focus Grou
Appendix D - Focus Group Moderator Guide.docx	Other-Moderator Guide for Focus Grou
Appendix E - Individual Interview Guide.docx	Other-Interview Guide for Individual
Appendix E - Individual Interview Guide.docx	Other-Interview Guide for Individual
Appendix F - Focus Group Consent Form.docx	Other-Consent Form for Focus Group
Appendix F - Focus Group Consent Form.docx	Other-Consent Form for Focus Group
Appendix G - Individual Interview Consent Form.docx	Other-Consent Form for Individual In
Appendix G - Individual Interview Consent Form.docx	Other-Consent Form for Individual In
0695 OMB Approval Memo - Exploring Healthcare Providers Perspective 2021.docx OMB approval memo	IC Document
0695 OMB Approval Memo - Exploring Healthcare Providers Perspective 2021.docx OMB approval memo	IC Document

IC Title:

Exploring Healthcare Providers' Practices, Perspectives, and Experiences Prescribing and Co-Prescribing Benzodiazepines and Opioids (CDER)

Agency IC Tracking Number:

CDER

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Focus Group Screener	Appendix A - Focus Group Screener.docx	Yes	Yes	Fillable Fileable
Other-Interview Screener	Appendix B - Interview Screener.docx	Yes	Yes	Fillable Fileable
Other-Recruitment Outreach for FGs and IDIs	Appendix C - Recruitment Outreach for FGs and IDIs.docx	Yes	No	Printable Only
Other-Moderator Guide for Focus Groups	Appendix D - Focus Group Moderator Guide.docx	Yes	No	Printable Only
Other-Interview Guide for Individuals	Appendix E - Individual Interview Guide.docx	Yes	No	Printable Only
Other-Consent Form for Focus Group	Appendix F - Focus Group Consent Form.docx	Yes	Yes	Fillable Fileable
Other-Consent Form for Individual Interviews	Appendix G - Individual Interview Consent Form.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,504

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	3,504	3,504
Annual IC Time Burden (Hours)	801	801
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB approval memo	0695 OMB Approval Memo - Exploring Healthcare Providers Perspective 2021.docx	09/22/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.