RCORP – Overdose Response (NEW)

Rural Communities Opioid Response Program (RCORP) Grantee Data

Documents and Forms

Document Name Document Type
Form 5 RCORP – Overdose Response (NEW) Form and Instruction
5 RCORP Overdose Response FINAL 07092024 RCORP Overdose Response FINAL 07092024.docx Form and Instruction
5 RCORP Overdose Response FINAL 07092024 RCORP Overdose Response FINAL 07092024.docx Form and Instruction

Information Collection (IC) Details

IC Title:	RCORP – Overdose Response (NEW)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	5	RCORP Overdose Response FINAL 07092024	RCORP Overdose Response FINAL 07092024.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 47	Number of Respondents for Small Entity: 47

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	141	141
Annual IC Time Burden (Hours)	79	79
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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