OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Exploring Healthcare Providers' Practices, Perspectives, and Experiences Prescribing and Co-Prescribing Benzodiazepines and Opioids (CDER)

IC 249440 under ICR 202206-0910-015 · OMB 0910-0695.

Documents and Forms
Document Name
Document Type
Other-Focus Group Screener
Other-Focus Group Screener
Other-Interview Screener
Other-Interview Screener
Other-Recruitment Outreach for FGs a
Other-Recruitment Outreach for FGs a
Other-Moderator Guide for Focus Grou
Other-Moderator Guide for Focus Grou
Other-Interview Guide for Individual
Other-Interview Guide for Individual
Other-Consent Form for Focus Group
Other-Consent Form for Focus Group
Other-Consent Form for Individual In
Other-Consent Form for Individual In
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Exploring Healthcare Providers' Practices, Perspectives, and Experiences Prescribing and Co-Prescribing Benzodiazepines and Opioids (CDER) CDER
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Focus Group Screener Appendix A - Focus Group Screener.docx Yes Yes Fillable Fileable
Other-Interview Screener Appendix B - Interview Screener.docx Yes Yes Fillable Fileable
Other-Recruitment Outreach for FGs and IDIs Appendix C - Recruitment Outreach for FGs and IDIs.docx Yes No Printable Only
Other-Moderator Guide for Focus Groups Appendix D - Focus Group Moderator Guide.docx Yes No Printable Only
Other-Interview Guide for Individuals Appendix E - Individual Interview Guide.docx Yes No Printable Only
Other-Consent Form for Focus Group Appendix F - Focus Group Consent Form.docx Yes Yes Fillable Fileable
Other-Consent Form for Individual Interviews Appendix G - Individual Interview Consent Form.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

3,504 0
   
Individuals or Households
 
   0 %

  Requested 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 3,504 0 0 0 0 3,504
Annual IC Time Burden (Hours) 801 0 0 0 0 801
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB approval memo 0695 OMB Approval Memo - Exploring Healthcare Providers Perspective 2021.docx 09/22/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.