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Injection Drug Use Surveillance Project
Injection Drug Use Surveillance Project
OMB: 0920-1325
IC ID: 242583
OMB.report
HHS/CDC
OMB 0920-1325
ICR 202108-0920-005
IC 242583
( )
Documents and Forms
Document Name
Document Type
Injection Drug Use Surveillance Project
Form and Instruction
Project Permission Form
Att 6 Project Permission Form.docx
Form and Instruction
Project Permission Form
Att 6 Project Permission Form.docx
Form and Instruction
Eligibility screening form
Approved_IDU_survey_wscreener_track changes_OMB 0920-1325_clean.docx
Form and Instruction
Eligibility screening form
Approved_IDU_survey_wscreener_track changes_OMB 0920-1325_clean.docx
Form and Instruction
IDU Survey with proposed changes (August 2021)
Approved_IDU_survey_track changes_OMB 0920-1325_final.docx
Form and Instruction
IDU Survey with proposed changes (August 2021)
Approved_IDU_survey_track changes_OMB 0920-1325_final.docx
Form and Instruction
Att 11 Screenshots of IDU survey in REDCap.pdf
Screenshots of IDU survey in REDCap
IC Document
Att 11 Screenshots of IDU survey in REDCap.pdf
Screenshots of IDU survey in REDCap
IC Document
Changes to IDU survey and justifications_OMB 0920-1325.xlsx
Crosswalk and Discussion of Proposed Changes (March 2021)
IC Document
Changes to IDU survey and justifications_OMB 0920-1325.xlsx
Crosswalk and Discussion of Proposed Changes (March 2021)
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Injection Drug Use Surveillance Project
Agency IC Tracking Number:
NEW
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
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
N/A
Project Permission Form
Att 6 Project Permission Form.docx
Yes
Yes
Fillable Fileable
Form and Instruction
N/A
Eligibility screening form
Approved_IDU_survey_wscreener_track changes_OMB 0920-1325_clean.docx
Yes
Yes
Fillable Fileable
Form and Instruction
n/a
IDU Survey with proposed changes (August 2021)
Approved_IDU_survey_track changes_OMB 0920-1325_final.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
28,499
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
28,499
0
0
0
0
28,499
Annual IC Time Burden (Hours)
6,125
0
0
0
0
6,125
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Screenshots of IDU survey in REDCap
Att 11 Screenshots of IDU survey in REDCap.pdf
07/06/2020
Crosswalk and Discussion of Proposed Changes (March 2021)
Changes to IDU survey and justifications_OMB 0920-1325.xlsx
03/31/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.