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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Exploring Healthcare Providers' Practices, Perspectives, and Experiences Prescribing and Co-Prescribing Benzodiazepines and Opioids (CDER)
Agency IC Tracking Number:
CDER
IC Status:
Unchanged
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-Focus Group Screener
Appendix A - Focus Group Screener.docx
Yes
Yes
Fillable Fileable
Other-Interview Screener
Appendix B - Interview Screener.docx
Yes
Yes
Fillable Fileable
Other-Recruitment Outreach for FGs and IDIs
Appendix C - Recruitment Outreach for FGs and IDIs.docx
Yes
No
Printable Only
Other-Moderator Guide for Focus Groups
Appendix D - Focus Group Moderator Guide.docx
Yes
No
Printable Only
Other-Interview Guide for Individuals
Appendix E - Individual Interview Guide.docx
Yes
No
Printable Only
Other-Consent Form for Focus Group
Appendix F - Focus Group Consent Form.docx
Yes
Yes
Fillable Fileable
Other-Consent Form for Individual Interviews
Appendix G - Individual Interview Consent Form.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,504
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
3,504
0
0
0
0
3,504
Annual IC Time Burden (Hours)
801
0
0
0
0
801
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB approval memo
0695 OMB Approval Memo - Exploring Healthcare Providers Perspective 2021.docx
09/22/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.