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(CBER) Submissions related to expanded access and treatment of an individual patient
Expanded Access to Investigational Drugs for Treatment Use
OMB: 0910-0814
IC ID: 253121
OMB.report
HHS/FDA
OMB 0910-0814
ICR 202309-0910-005
IC 253121
( )
Documents and Forms
Document Name
Document Type
Form FDA 3926
(CBER) Submissions related to expanded access and treatment of an individual patient
Form
FDA-3926_instructions.pdf
Instruction
FDA-3926_instructions.pdf
Instruction
eSubmitter Screenshots.pdf
Other-eSubmitter Screenshots
eSubmitter Screenshots.pdf
Other-eSubmitter Screenshots
0814_Guidance.pdf
Other-Agency Guidance
0814_Guidance.pdf
Other-Agency Guidance
FDA 3926 Individual Patient Expanded Access Investigational
Form FDA 3926.pdf
Form
FDA 3926 Individual Patient Expanded Access Investigational
Form FDA 3926.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
(CBER) Submissions related to expanded access and treatment of an individual patient
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
21 CFR 312
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
FDA 3926
Individual Patient Expanded Access Investigational
Form FDA 3926.pdf
Yes
Yes
Fillable Fileable
Instruction
FDA-3926_instructions.pdf
Yes
No
Printable Only
Other-eSubmitter Screenshots
eSubmitter Screenshots.pdf
Yes
No
Fillable Fileable Signable
Other-Agency Guidance
0814_Guidance.pdf
Yes
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
118
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
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
0
0
0
-154
0
154
Annual IC Time Burden (Hours)
0
0
0
-1,232
0
1,232
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.