Feedback on Strategies Related to Opioid Misuse

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Feedback on Strategies Related to Opioid Misuse Form and Instruction
1 Feedback Form on Strategies Related to Opioid Misuse Feedback Form on Strategies Related to Opioid Misuse.docx Form and Instruction
fast-track-submission-form-OHS-11-5-18.doc Justification IC Document

Information Collection (IC) Details

IC Title:	Feedback on Strategies Related to Opioid Misuse	Agency IC Tracking Number:

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
Form and Instruction	1	Feedback Form on Strategies Related to Opioid Misuse	Feedback Form on Strategies Related to Opioid Misuse.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,574	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	1,574	1,574
Annual IC Time Burden (Hours)	131	131
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification	fast-track-submission-form-OHS-11-5-18.doc	11/06/2018

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