View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Prescription Drug Use Related Software Study (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-Screeners			Appendix A - Screeners.docx		Yes	Yes	Fillable Fileable
Other-Confirmation and Reminder Emails			Appendix B - Confirmation and Reminder Email.docx		Yes	No	Printable Only
Other-Consent Form			Appendix C - Informed Consent.docx		Yes	No	Printable Only
Other-Moderator Guide			Appendix D - Moderator Guide.docx		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: 186	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	186	0	186	0	0	0
Annual IC Time Burden (Hours)	54	0	54	0	0	0
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 - Prescription Drug Use Related Software 2021.docx	12/14/2021

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