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Rapid ED Data Submission Template
[NCIPC] Drug Overdose Surveillance and Epidemiology (DOSE)
Att D - Rapid_ED_Data Submission Template_2.9.22.xlsx
Rapid ED Overdose Data from Local Syndromic or Hospital Discharge File
OMB: 0920-1268
OMB.report
HHS/CDC
OMB 0920-1268
ICR 202303-0920-004
IC 236480
Rapid ED Data Submission Template
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-1268 can be found here:
2025-06-26 - Revision of a currently approved collection
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