Information Collection

Drug Abuse Warning Network (DAWN)

IC 7494 under ICR 202408-0930-001 · OMB 0930-0078.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DAWN Case Report F Drug Abuse Warning Network (DAWN)	Form and Instruction
DAWN Case Report F DAWN Case Report Form Attachment A DAWN ED Case Report Form_202408.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DAWN Case Report Form	DAWN Case Report Form	Attachment A DAWN ED Case Report Form_202408.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 143

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	143	143
Annual IC Time Burden (Hours)	11,655	11,655
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.