Request for Opioid Project Information from Patient Safety Organizations (PSOs)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

OMB: 0935-0179

IC ID: 232977

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Request for Opioid Project Information from Patient Safety Organizations (PSOs)
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Request for Opioid Project Information FINAL Request for Opioid Project Info 9.10.18 (002).docx Yes Yes Fillable Fileable

Health Health Care Services

 

40 0
   
Private Sector Not-for-profit institutions
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 40 0 0 0 0 40
Annual IC Time Burden (Hours) 7 0 0 0 0 7
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement Fast Track AHRQ PSO Opioid Summit.docx 09/11/2018
Cover Letter Cover Page.doc 09/11/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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