Information Collection Request
Notification of Intent to Use Schedule III, IV, or V Opioid Drugs for the Maintenance and Detoxification Treatment of Opiate Addiction
ICR 202211-0930-002 · OMB 0930-0234 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form NOI Qualifying Oth Qualifying Other Practitioner |
Form and Instruction | Modified | Repair queued |
| Form All Practitioner R Practitioner Reporting Form |
Form and Instruction | Modified | Missing upstream |
| Form NOI 275 All Practi Notice to Treat up to 275 Patients |
Form and Instruction | Modified | Repair queued |
| Form NOI Physicians 30 Notice to Treat up to 100 Patients |
Form and Instruction | Modified | Repair queued |
 Supporting Statement for NOIs_OMB No. 0930-0234 _ 11-7-2022.docx |
Supporting Statement A | Uploaded 2022-11-07 | Repair queued |
| NOI Qualifying Other Practitioner NP and PA 30 and 100_30E_Revised OIRA Questions and Edits_CLEAN.docx |
Supplementary Document | Uploaded 2021-05-26 | Repair queued |
| 0930-0234 NOI _ No Material or Nonsubstantive Change_5-26-2021_CLEAN.docx |
Supplementary Document | Uploaded 2021-05-26 | Repair queued |
| 0930-0234 NOI _ No Material or Nonsubstantive Change_5-26-2021_CLEAN.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2021-05-26 | Repair queued |
| Attachment A Final NOI Physicians 30 and 100 Waiver- 01.24.2020.docx |
Supplementary Document | Uploaded 2020-01-29 | Repair queued |
 Attachment D - Notice of Intent.pdf |
Supplementary Document | Uploaded 2016-09-26 | Repair queued |
| Attachment A - DATA 2000.pdf |
Supplementary Document | Uploaded 2016-07-12 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 7645 |  Notification of Intent |
Instruction | Modified | |
| 223711 | Qualifying Other Practitioner |
Form and Instruction | Modified | |
| 222817 | Request for a Temporary Patient Increase Patient Increase for an Emergency - 8.655 |
Instruction | Modified | |
| 222816 | Practitioner Reporting Form |
Form and Instruction | Modified | |
| 222815 | Renewal Request for a Patient Limit Increase - 8.64 |
Instruction | Modified | |
| 222813 | Request for Patient Limit - 8.620 |
Instruction | Modified | |
| 222812 | Notice to Treat up to 275 Patients |
Form and Instruction | Modified | |
| 222811 | Notice to Treat up to 100 Patients |
Form and Instruction | Modified | |
| 222810 | Notification to Prescribe Immediately |
Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/SAMHSA |
| OMB Control No | 0930-0234 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202105-0930-001 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |