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Information Collection

Rapid Message Testing with Consumer Panel - Transmucosal Immediate Release Fentanyl Patient Presriber Agreement Form

IC 235559 under ICR 201712-0910-001 · OMB 0910-0695.

Documents and Forms
Document Name
Document Type
Other-Participant Screener
Other-Patient Prescriber Agreement F
Other-Interview Guide
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Rapid Message Testing with Consumer Panel - Transmucosal Immediate Release Fentanyl Patient Presriber Agreement Form CDER
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Participant Screener Participant Screener.docx Yes Yes Fillable Fileable
Other-Patient Prescriber Agreement Form Patient Prescriber Agreement Form.docx Yes Yes Fillable Fileable
Other-Interview Guide Interview Guide.docx Yes No Paper Only

Health Consumer Health and Safety

 

400 0
   
Individuals or Households
 
   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 400 0 400 0 0 0
Annual IC Time Burden (Hours) 31 0 31 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB Approval Memo 0695 OMB Approval Memo - Transmucosal Immediate Release Fentanyl PPA Form 2019.DOCX 04/02/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.