Information Collection

Confidentiality of Alcohol and Drug Abuse Patient Records - 42 CFR Part 2

IC 7502 under ICR 200708-0930-001 · OMB 0930-0092.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0092 can be found here:

Documents and Forms

Document Name Document Type
SAMHSAHIPAAComparisonClearedPDFVersion.pdf Other-Regulation and HIPAA Rule

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Confidentiality of Alcohol and Drug Abuse Patient Records - 42 CFR Part 2	Agency IC Tracking Number:

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
Other-Regulation and HIPAA Rule			SAMHSAHIPAAComparisonClearedPDFVersion.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10,629	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,849,548	89,022	0	1,760,526
Annual IC Time Burden (Hours)	369,910	16,561	0	353,349
Annual IC Cost Burden (Dollars)	73,982	0	-13,018	87,000

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.