View Information Collection (IC)
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Risk Evaluation and Mitigation Strategy (REMS) Programs to Promote Appropriate Medication Use and Knowledge: Physician Experiences with REMS Programs (CDER)
Agency IC Tracking Number:
CDER
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-Invitation
Invitation Letter.docx
Yes
No
Paper Only
Other-Consent Form
Consent Form.docx
Yes
No
Paper Only
Other-Survey - Ambrisentan
Physician Survey - Ambrisentan.docx
Yes
Yes
Fillable Fileable
Other-Survey - Bosentan
Physician Survey - Bosentan.docx
Yes
Yes
Fillable Fileable
Other-Survey - Clozapine
Physician Survey - Clozapine.docx
Yes
Yes
Fillable Fileable
Other-Survey - Isotretinoin
Physician Survey - Isotretinoin.docx
Yes
Yes
Fillable Fileable
Other-Survey - Lenalidomide-Pomalidomide-Thalidomide
Physician Survey - Lenalidomide-Pomalidomide-Thalidomide.docx
Yes
Yes
Fillable Fileable
Other-Survey - Sodium Oxybate
Physician Survey - Sodium Oxybate.docx
Yes
Yes
Fillable Fileable
Other-Reminder Letter
Reminder Letter.docx
Yes
No
Printable Only
Other-IRB Letter
IRB Approval Letter 2021P002109.pdf
Yes
No
Printable 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:
1,200
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
1,200
0
1,200
0
0
0
Annual IC Time Burden (Hours)
400
0
400
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Approval Memo
0847 OMB Approval Memo - REMS Physician Experience Surveys 2021.docx
11/23/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.