Information Collection

Injection Drug Use Surveillance Project

IC 242583 under ICR 202103-0920-011 · OMB 0920-1325.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1325 can be found here:

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 Att 3 Eligibility screening form.pdf Form and Instruction
Eligibility screening form Att 3 Eligibility screening form.pdf Form and Instruction
IDU Survey with proposed changes (March 2021) Approved_IDU_survey_track changes_OMB 0920-1325.docx Form and Instruction
IDU Survey with proposed changes (March 2021) Approved_IDU_survey_track changes_OMB 0920-1325.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	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	Att 3 Eligibility screening form.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	IDU Survey with proposed changes (March 2021)	Approved_IDU_survey_track changes_OMB 0920-1325.docx	Yes	Yes	Fillable Fileable

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	Previously Approved
Annual Number of Responses for this IC	28,499	28,499
Annual IC Time Burden (Hours)	6,125	6,125
Annual IC Cost Burden (Dollars)	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.