Information Collection Request

[NCIPC] Overdose Response Strategy Data Collection

ICR 202601-0920-001 · OMB 0920-1461 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-25AC ORS Annual Evaluation Survey- ORS MCT Form Unchanged Available
Form 0920-25AC ORS Annual Evaluation Survey- PSP Form Unchanged Available
Form 0920-25AC ORS Annual Evaluation Survey- PHP Form Unchanged Available
Form 0920-25AC ORS Annual Evaluation Survey- DIO Form Unchanged Repair queued
Form 0920-1461 ORS Quarterly Reporting Template 07JAN2026 Form and Instruction Modified Available
Form 0920-25AC ORS Quarterly Reporting Template Form Modified Available
Form 0920-25AC ORS Annual Evaluation Survey- PHA Form Unchanged Available
Form 0920-25AC ORS Annual Evaluation Reminder Email Form Unchanged Repair queued
Form 0920-25AC ORS Annual Evaluation Survey Invitation Form Unchanged Available
OMB 0920-1461 Change Request Memo.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-01-07 Available
OMB 0920-1461 change request crosswalk.docx Supplementary Document Uploaded 2026-01-07 Available
SSA_OMB 0920-1461 chang request clean.docx Supporting Statement A Uploaded 2026-01-07 Available
Att I1_Screenshot ORS Quarterly Reporting Template.pdf Supplementary Document Uploaded 2025-06-12 Repair queued
Att H1_Screenshot ORS Annual Survey MCT.pdf Supplementary Document Uploaded 2025-06-12 Available
Att F1_Screenshot ORS Annual Survey PHP.pdf Supplementary Document Uploaded 2025-06-12 Available
Att G1_Screenshot ORS Annual Survey PSP.pdf Supplementary Document Uploaded 2025-06-12 Available
Att E1_Sreenshot ORS Annual Survey DIO.pdf Supplementary Document Uploaded 2025-06-12 Available
Att D1_ Screenshot ORS Annual Survey PHA.pdf Supplementary Document Uploaded 2025-06-12 Available
Att J_ORS Logic Model.pptx Supplementary Document Uploaded 2025-06-12 Available
Att L1_screenshot ORS survey invite.pdf Supplementary Document Uploaded 2025-06-12 Repair queued
Att M1_screenshot ORS survey reminder.pdf Supplementary Document Uploaded 2025-06-12 Available
Att K_Research Determination ORS.pdf Supplementary Document Uploaded 2025-06-12 Available
Att C_Privacy Act Determination ORS.pdf Supplementary Document Uploaded 2025-06-12 Available
Att A_ Authorizing Legislation PHSA.docx Supplementary Document Uploaded 2025-06-12 Available
SSB_ORS Data Collection_Final.docx Supporting Statement B Uploaded 2025-06-12 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
275744 ORS Annual Evaluation Survey-ORS Management/Coordination Team Form UnchangedORS Annual Evaluation Survey- ORS MCT
275743 Att E_ORS Annual Evaluation Survey- Public Safety Form UnchangedORS Annual Evaluation Survey- PSP
275742 Att E_ORS Annual Evaluation Survey- Public Health Partner Form UnchangedORS Annual Evaluation Survey- PHP
275741 ORS Annual Evaluation Survey-DIO Form UnchangedORS Annual Evaluation Survey- DIO
275740 ORS Quarterly Reporting Template Form and Instruction ModifiedORS Quarterly Reporting Template 07JAN2026
275740 ORS Quarterly Reporting Template Form ModifiedORS Quarterly Reporting Template
275739 Annual Evaluation Survey-PHA Form UnchangedORS Annual Evaluation Survey- PHA
275738 Reminder Email Form UnchangedORS Annual Evaluation Reminder Email
275737 Invitation Email Form UnchangedORS Annual Evaluation Survey Invitation

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2028 08/31/2028 08/31/2028
1,349 0 1,349
653 0 653
0 0 0





Reginfo record details
8
table that charts list of burden
IC Title Form No. Form Name
Annual Evaluation Survey-PHA 0920-25AC
Att E_ORS Annual Evaluation Survey- Public Health Partner 0920-25AC
Att E_ORS Annual Evaluation Survey- Public Safety 0920-25AC
Invitation Email 0920-25AC
ORS Annual Evaluation Survey-DIO 0920-25AC
ORS Annual Evaluation Survey-ORS Management/Coordination Team 0920-25AC
ORS Quarterly Reporting Template 0920-25AC, 0920-1461 ,  
Reminder Email 0920-25AC

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,349 1,349 0 0 0 0
Annual Time Burden (Hours) 653 653 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No