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	Repair queued
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	Missing upstream
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
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