PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
ED Discharge Overdose data (annual reporting)
Removed
0
0
0
Form and Instruction
0920-1268
ED Annual Discharge Overdose Data Form
ED and hospitalization discharge overdose data form - Health Department ED and inpatient hospital metadata - yearly
New
32
96
0
Form and Instruction
0920-1268
ED and Hospitalization Discharge Overdose Data Form
Inpatient hospitalization discharge overdose data form - Health Department Line-level ED and Inpatient Hospitalization Discharge Data - Yearly
New
35
175
0
Form and Instruction
0920-1268
Inpatient Hospitalization Discharge Overdose Data Form
Inpatient hospitalization discharge overdose data form - Health Department Total Inpatient Hospitalization Visits and Metadata - Yearly
New
3
6
0
Form and Instruction
0920-1268
Inpatient Hospitalization Discharge Overdose Data Form
Rapid ED Overdose Data - Case-level Data Shared through NSSP Biosense
Removed
0
0
0
Form and Instruction
None
Rapid ED Data Submission Template
Rapid ED Overdose Data Form - Health Departments sharing data from Local Syndromic Data File
New
36
108
0
Form and Instruction
0920-1268
Rapid ED Overdose Death Form
Rapid ED Overdose Data from Local Syndromic or Hospital Discharge File
Removed
0
0
0
Form and Instruction
None
Rapid ED Data Submission Template
Rapid ED overdose Data Form - Health Departments sharing from NSSP BioSense
New
540
270
0
Form and Instruction
0920-1268
Rapid ED Overdose Death Form
Total burden requested under this ICR:
646
655
0
To view an IC, click on IC Title
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