Drug Abuse Warning Network (DAWN)

Documents and Forms

Document Name Document Type
Form DAWN Case Report F Drug Abuse Warning Network (DAWN) Form and Instruction
DAWN Case Report F DAWN Case Report Form Attachment A DAWN ED Case Report Form_202408.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Drug Abuse Warning Network (DAWN)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

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	DAWN Case Report Form	DAWN Case Report Form	Attachment A DAWN ED Case Report Form_202408.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 143	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	143	143
Annual IC Time Burden (Hours)	11,655	11,655
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.