Information Collection Request

[NCIPC] Comprehensive Evaluation of the Implementation and Uptake of the CDC Clinical Practice Guideline for Prescribing Opioids for Pain

ICR 202603-0920-005 · OMB 0920-1459 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Caregiver Focus Group Guide Form and Instruction Unchanged Available
Patient Focus Group Guide Form and Instruction Unchanged Available
Medical Board Leaders Interview Guide Form and Instruction Unchanged Available
Professional Association Leaders Interview Guide Form and Instruction Unchanged Repair queued
Payer Interview Guide Form and Instruction Unchanged Available
Health System Leaders Interview Guide Form and Instruction Unchanged Available
Dentist Interview Guide Form and Instruction Unchanged Available
Clinician Interview Guide Form and Instruction Unchanged Available
Clinician Follow-Up Email Form and Instruction Unchanged Available
Clinician Invitation Form and Instruction Unchanged Available
Form 0920-26-0130 Clinican Survey Form and Instruction Modified Available
Clinician Survey Form and Instruction Modified Repair queued
OMB #0920-1459_Crosswalk Template Non substantial change.xlsx Supplementary Document Uploaded 2026-03-09 Available
OMB #0920-1459_Change Request Memo.docx Supplementary Document Uploaded 2026-03-09 Available
Change Request Memo - 0920-1459.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-08-27 Available
Attachment M_Privacy Impact Assessment.pdf Supplementary Document Uploaded 2024-12-12 Available
Attachment L_IRB Approval Documentation.pdf Supplementary Document Uploaded 2024-12-12 Available
Attachment A_AuthLeg.docx Supplementary Document Uploaded 2024-12-12 Available
Attachment B_ 60 Dy FRN Evaluation CDC Clinical Guideline.pdf Supplementary Document Uploaded 2024-12-12 Available
SSB 1459 Evaluation CDC Clinical Guideline - Clean.docx Supporting Statement B Uploaded 2025-08-27 Available
Evaluation CDC Clinical Guideline SSA_Feb 2026 clean.docx Supporting Statement A Uploaded 2026-03-09 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
272991 Caregiver Focus Groups Form and Instruction UnchangedCaregiver Focus Group Guide
272991 Caregiver Focus Groups Form and Instruction Unchanged
272989 Patient Focus Groups Form and Instruction UnchangedPatient Focus Group Guide
272989 Patient Focus Groups Form and Instruction Unchanged
272988 Medical Board Leaders Interview Form and Instruction UnchangedMedical Board Leaders Interview Guide
272988 Medical Board Leaders Interview Form and Instruction Unchanged
272987 Professional Association Leaders Interview Form and Instruction UnchangedProfessional Association Leaders Interview Guide
272987 Professional Association Leaders Interview Form and Instruction Unchanged
272986 Payer Interview Form and Instruction UnchangedPayer Interview Guide
272986 Payer Interview Form and Instruction Unchanged
272985 Health System Leaders Interview Form and Instruction UnchangedHealth System Leaders Interview Guide
272985 Health System Leaders Interview Form and Instruction Unchanged
272984 Dentist Interview Form and Instruction UnchangedDentist Interview Guide
272984 Dentist Interview Form and Instruction Unchanged
272983 Clinician Interview Form and Instruction UnchangedClinician Interview Guide
272983 Clinician Interview Form and Instruction Unchanged
272982 Clinician - Follow-Up Emails Form and Instruction UnchangedClinician Follow-Up Email
272982 Clinician - Follow-Up Emails Form and Instruction Unchanged
272981 Clinician - Invitation Form and Instruction UnchangedClinician Invitation
272981 Clinician - Invitation Form and Instruction Unchanged
272978 Clinician - Clinician Survey Form and Instruction ModifiedClinican Survey
272978 Clinician - Clinician Survey Form and Instruction ModifiedClinician Survey
272978 Clinician - Clinician Survey Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
06/30/2028 06/30/2028 06/30/2028
2,311 0 2,311
310 0 310
0 0 0





Reginfo record details
11
table that charts list of burden
IC Title Form No. Form Name
Caregiver Focus Groups N/A
Clinician - Clinician Survey N/A, 0920-26-0130 ,  
Clinician - Follow-Up Emails N/A
Clinician - Invitation N/A
Clinician Interview N/A
Dentist Interview N/A
Health System Leaders Interview N/A
Medical Board Leaders Interview N/A
Patient Focus Groups N/A
Payer Interview N/A
Professional Association Leaders Interview N/A

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 2,311 2,311 0 0 0 0
Annual Time Burden (Hours) 310 310 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No