Information Collection Request
[NCIPC] Drug Overdose Surveillance and Epidemiology (DOSE)
ICR 202303-0920-004 · OMB 0920-1268 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-1268 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 0920-1268 ED Discharge Overdose data (annual reporting) |
Form and Instruction | Modified | Missing upstream |
| ED Discharge Overdose data (quarterly reporting) |
Form and Instruction | Removed | Repair queued |
| Rapid ED Overdose Data - Case-level Data Shared through NSSP Biosense |
Form and Instruction | Modified | Missing upstream |
| Rapid ED Overdose Data from Local Syndromic or Hospital Discharge File |
Form and Instruction | Unchanged | Missing upstream |
 Crosswalk of Changes OMB_DOP_ADS (1).xlsx |
Supplementary Document | Uploaded 2023-03-09 | Repair queued |
 DOSE Request Non substantial change_DOPADSedits_030823.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2023-03-09 | Repair queued |
 Att F_Privacy Act Applicability.pdf |
Supplementary Document | Uploaded 2022-02-17 | Repair queued |
| Att D2_ Changes Crosswalk OMB.xlsx |
Supplementary Document | Uploaded 2022-02-17 | Repair queued |
| Att C_Research Determination.pdf |
Supplementary Document | Uploaded 2022-02-17 | Repair queued |
| Att B_ 60 Dy FRN DOSE 1268.pdf |
Supplementary Document | Uploaded 2022-02-17 | Repair queued |
| Att A2 - Authorizing Legislation Substance Use-Disorder Prevention.docx |
Supplementary Document | Uploaded 2022-02-17 | Missing upstream |
| Att A1 - Authorizing Legislation PHSA.docx |
Supplementary Document | Uploaded 2022-02-17 | Missing upstream |
| SSB_DOSE_02092022.docx |
Supporting Statement B | Uploaded 2022-02-17 | Repair queued |
| SSA_DOSE_2.9.22.docx |
Supporting Statement A | Uploaded 2022-02-17 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 236483 |  ED Discharge Overdose data (annual reporting) |
Form and Instruction | Modified | |
| 236482 | ED Discharge Overdose data (quarterly reporting) |
Form and Instruction | Removed | |
| 236481 | Rapid ED Overdose Data - Case-level Data Shared through NSSP Biosense |
Form and Instruction | Modified | |
| 236480 | Rapid ED Overdose Data from Local Syndromic or Hospital Discharge File |
Form and Instruction | Unchanged |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-1268 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202202-0920-002 |
| Agency Tracking No | 0920-1268-23DH |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |