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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Rowan University School of Osteopathic Medicine (SOM)
Agency IC Tracking Number:
IC Status:
New
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
Other-PRE Assessment
Opioid Prescribing Presentation Pre Assessment_ Qualtrics_Medical Students_Final.docx.pdf
No
Paper Only
Other-Satisfaction Survey
Opioid Prescribing Presentation Satisfaction Survey_Residents.docx
No
Paper Only
Other-Satisfaction for Medical students
Opioid Prescribing Presentation Satisfaction Survey_Medical Students.docx
No
Paper Only
Other-Post Assessment
Opioid Prescribing Presentation Post Assessment_Residents.docx
No
Paper Only
Other-Assessment Medical Students
Opioid Prescribing Presentation Post Assessment_Medical Students.docx
No
Fillable Printable
Other-Pre Assessment Residents
Opioid Prescribing Presentation Pre Assessment_Residents.docx
Pre -Assessment Residents
No
Paper Only
Other-Pre-Assessment Medical Students
Opioid Prescribing Presentation Pre Assessment_Medical Students.docx
No
Paper Only
Other-Qualtrics
Opioid Prescribing Presentation Pre Assessment_ Qualtrics_Medical Students_Final.docx.pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
300
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
300
0
300
0
0
0
Annual IC Time Burden (Hours)
25
0
25
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SS_A
OMB_Clearance_Submission_Form_OWHPA - Rowan Univ. SOM.doc
08/07/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.