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ACOG Full Online/Paper Survey
Practice Patterns related to Opioid Use during Pregnancy and Lactation
OMB: 0920-1168
IC ID: 223394
OMB.report
HHS/CDC
OMB 0920-1168
ICR 201609-0920-001
IC 223394
( )
Documents and Forms
Document Name
Document Type
ACOG Full Online/Paper Survey
Form and Instruction
ACOG Practice Patterns related to Opioid Use during Preg
8 Att4a_Full Online Survey.pdf
Form and Instruction
ACOG Practice Patterns related to Opioid Use during Preg
9 Att4b_Full Paper Survey.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
ACOG Full Online/Paper Survey
Agency IC Tracking Number:
Is this a Common Form?
No
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
Form and Instruction
NA
ACOG Practice Patterns related to Opioid Use during Pregnancy and Lactation - FULL ONLINE
8 Att4a_Full Online Survey.pdf
NA
Yes
Yes
Fillable Fileable
Form and Instruction
NA
ACOG Practice Patterns related to Opioid Use during Pregnancy and Lactation - FULL PAPER
9 Att4b_Full Paper Survey.docx
NA
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:
420
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
90 %
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
420
0
420
0
0
0
Annual IC Time Burden (Hours)
105
0
105
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.