IPRO Drug Safety Program Collaborator Survey (CMS-10770)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (CMS-10415)

OMB: 0938-1185

IC ID: 257135

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

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IPRO Drug Safety Program Collaborator Survey (CMS-10770)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10770 IPRO Collaborator Drug Safety Survey CMS-10770 2022 IPRO Collaborator - Drug Safety.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

16 2
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 16 0 16 0 0 0
Annual IC Time Burden (Hours) 3 0 3 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-10770 Supporting Statement CMS-10770 Generic_Clearance_Submission_IPRO - Drug Safety V2.doc.docx 11/28/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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