CDER COVID-19 Critical Care Drug Monitoring Survey Portal

Rapid Response Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0500 can be found here:

Documents and Forms

Document Name Document Type
Email Invitation final.docx Other-Email invitation
COVID-19 Critical Care Drug Monitoring Survey Portal Reference Guide.pdf Other-Reference guide
Survey Questions final.docx Other-Survey
0500 OMB Memo COVID19 Critical Care 2023 FINAL.docx OMB Memo / Abbreviated Supporting Statement IC Document
FDA PHE PRA Waiver Notice COVID-19 Surveys.pdf PHE waiver IC Document

Information Collection (IC) Details

IC Title:	CDER COVID-19 Critical Care Drug Monitoring Survey Portal	Agency IC Tracking Number:	CDER

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Email invitation	Email Invitation final.docx	Yes	No	Printable Only
Other-Reference guide	COVID-19 Critical Care Drug Monitoring Survey Portal Reference Guide.pdf	Yes	No	Printable Only
Other-Survey	Survey Questions final.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	15,600	15,600
Annual IC Time Burden (Hours)	3,900	3,900
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo / Abbreviated Supporting Statement	0500 OMB Memo COVID19 Critical Care 2023 FINAL.docx	03/16/2023
PHE waiver	FDA PHE PRA Waiver Notice COVID-19 Surveys.pdf	03/16/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.