Translating Evidence to Practice Implementation Tools for Preventing Overdose

[OADC] CDC Usability and Digital Content Testing

Documents and Forms

Document Name Document Type
Form 0920-1050 Translating Evidence to Practice Implementation Tools for Preventing Overdose Form and Instruction
0920-1050 Recruitment Letter Recruitment email_Att 2.docx Form and Instruction
0920-1050 Tools for Overdose Prevention Survey Tools for Overdose Survey_Att 1.pdf Form and Instruction
0080 NCMW 1050 Request Template Service Delivery_UPDATED - 3-3-25.docx 0920-1050 GenIC Request Template IC Document

Information Collection (IC) Details

IC Title:	Translating Evidence to Practice Implementation Tools for Preventing Overdose	Agency IC Tracking Number:	0920-1050-25-0037

IC Status: Unchanged

Obligation to Respond: Voluntary

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	0920-1050	Recruitment Letter	Recruitment email_Att 2.docx	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1050	Tools for Overdose Prevention Survey	Tools for Overdose Survey_Att 1.pdf	N/A	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 540	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	540	540
Annual IC Time Burden (Hours)	189	189
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0920-1050 GenIC Request Template	0080 NCMW 1050 Request Template Service Delivery_UPDATED - 3-3-25.docx	03/07/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.