Retrieving and Refiling Records - Data Elements

[NCIPC] State Unintentional Drug Overdose Reporting System (SUDORS)

Documents and Forms

Document Name Document Type
Retrieving and Refiling Records - Data Elements Form and Instruction
SUDORS Case Report - Retrieving and Refiling Records Att D_SUDORS_Data_Elements_December2025.pdf Form and Instruction
Att E_Retrieving and refiling records_SUDORS Screenshots_2025_ygg9.pdf Screen Shots for SUDORS Data Elements IC Document

Information Collection (IC) Details

IC Title:	Retrieving and Refiling Records - Data Elements	Agency IC Tracking Number:	0920-1128

Is this a Common Form? No		IC Status: Modified

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	n/a	SUDORS Case Report - Retrieving and Refiling Records	Att D_SUDORS_Data_Elements_December2025.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 51	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	87,261	87,261
Annual IC Time Burden (Hours)	43,631	43,631
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Screen Shots for SUDORS Data Elements	Att E_Retrieving and refiling records_SUDORS Screenshots_2025_ygg9.pdf	01/27/2026

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