Information Collection Request

[NCIPC] Overdose Response Strategy Data Collection

ICR 202611-0920-001 · OMB 0920-1461 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
ORS Annual Evaluation Survey Form Modified Available
Form 0920-25AC ORS Annual Evaluation Survey- PSP Form Removed Available
ORS Quarterly Reporting Survey Form Modified Available
ORS Annual Evaluation Survey- DIO Form Modified Available
ORS Quarterly Reporting Template Form and Instruction Modified Available
ORS Annual Evaluation Survey- PHA Form Modified Available
ORS Annual Evaluation Reminder Email Form Modified Available
ORS Annual Evaluation Survey Invitation Form Modified Available
Att B1 Public Comments.Responses 60day FRN.pdf Public Comments Uploaded 2026-08-21 Available
OMB Revision Request Memo_Aug 2026.docx Supplementary Document Uploaded 2026-11-09 Available
Att G Research Determination ORS.pdf Supplementary Document Uploaded 2026-11-09 Available
Att F Updated ORS Logic Model.pdf Supplementary Document Uploaded 2026-11-09 Available
Att C NCIPC Information Collection Request PII and Privacy Act Determination ORS.pdf Supplementary Document Uploaded 2026-11-09 Available
Att B Published 60day FRN.pdf Supplementary Document Uploaded 2026-11-09 Available
SSA_ORS Data Collection_2026 revision v05_final.docx Supporting Statement A Uploaded 2026-11-09 Available
Att A_ Authorizing Legislation PHSA.docx Supplementary Document Uploaded 2026-11-09 Available
SSB_ORS Data Collection_2026 revision v02.docx Supporting Statement B Uploaded 2026-11-09 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
275744 ORS Annual Evaluation Survey - Public Health and Public Safety Partners Form ModifiedORS Annual Evaluation Survey
275743 Att E_ORS Annual Evaluation Survey- Public Safety Form RemovedORS Annual Evaluation Survey- PSP
275742 ORS Quarterly Reporting Template - DIO Form ModifiedORS Quarterly Reporting Survey
275741 ORS Annual Evaluation Survey-DIO Form ModifiedORS Annual Evaluation Survey- DIO
275740 ORS Quarterly Reporting Template Form and Instruction ModifiedORS Quarterly Reporting Template
275739 Annual Evaluation Survey-PHA Form ModifiedORS Annual Evaluation Survey- PHA
275738 Reminder Email Form ModifiedORS Annual Evaluation Reminder Email
275737 Invitation Email Form ModifiedORS Annual Evaluation Survey Invitation

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 08/31/2028
1,274 1,349
327 653
0 0





Reginfo record details
7
table that charts list of burden
IC Title Form No. Form Name
Annual Evaluation Survey-PHA n/a
Att E_ORS Annual Evaluation Survey- Public Safety 0920-25AC
Invitation Email n/a
ORS Annual Evaluation Survey - Public Health and Public Safety Partners n/a
ORS Annual Evaluation Survey-DIO n/a
ORS Quarterly Reporting Template n/a
ORS Quarterly Reporting Template - DIO n/a
Reminder Email n/a

table that charts list of burden
  Total Request 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 1,274 1,349 0 -5 -70 0
Annual Time Burden (Hours) 327 653 0 -291 -35 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No