Information Collection

Rural Communities Opioid Response Program – MAT Access

IC 260924 under ICR 202507-0906-002 · OMB 0906-0044.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0044 can be found here:

Documents and Forms

Document Name Document Type
Form 3 Rural Communities Opioid Response Program – MAT Access Form and Instruction
3 Rural Communities Opioid Response Program – MAT Access MAT Access Measures to Share APPROVED (2023 Unchanged).pdf Form and Instruction
3 Rural Communities Opioid Response Program – MAT Access MAT Access Measures to Share APPROVED (2023 Unchanged).pdf Form and Instruction
3 (Revised) Attachment D_RCORP-MAT Access Measures - Proposed Revisi Attachment D_RCORP-MAT Access Measures - Proposed Revision.pdf Form and Instruction
3 (Revised) Attachment D_RCORP-MAT Access Measures - Proposed Revisi Attachment D_RCORP-MAT Access Measures - Proposed Revision.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Rural Communities Opioid Response Program â MAT Access	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3	Rural Communities Opioid Response Program â MAT Access	MAT Access Measures to Share APPROVED (2023 Unchanged).pdf		Yes	Yes	Fillable Fileable
Form and Instruction	3 (Revised)	Attachment D_RCORP-MAT Access Measures - Proposed Revision	Attachment D_RCORP-MAT Access Measures - Proposed Revision.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11	Number of Respondents for Small Entity: 11

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	11	11
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	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.

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