Information Collection

Health Behavior and School Experiences Survey

IC 46537 under ICR 200612-1850-005 · OMB 1850-0818.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1850-0818 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix A Active Consent Form Final revised.doc	Other-consent form
Health Behavior and School Experience Survey Appendix B Student Survey Final revised.doc	Form and Instruction

IC Title:

Health Behavior and School Experiences Survey

Agency IC Tracking Number:

3244

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-consent form			Appendix A Active Consent Form Final revised.doc		No		Paper Only
Form and Instruction	N/A	Health Behavior and School Experience Survey	Appendix B Student Survey Final revised.doc		No		Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	11,400	11,400
Annual IC Time Burden (Hours)	11,400	11,400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.