Information Collection

NHIS Children's Mental Health Services Questions

IC 183395 under ICR 200801-0920-008 · OMB 0920-0222.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form No number NHIS Children's Mental Health Services Questions	Form and Instruction
No number Testing NHIS Children's Mental Health Services Questions QDRL OMB-10-day package Children's Mental Health Svs -Attach 2-011008.doc	Form and Instruction
QDRL OMB-10-day package Children's Mental Health Svs -Attach 1-011008.doc Flyer	IC Document

IC Title:

NHIS Children's Mental Health Services Questions

Agency IC Tracking Number:

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
Form and Instruction	No number	Testing NHIS Children's Mental Health Services Questions	QDRL OMB-10-day package Children's Mental Health Svs -Attach 2-011008.doc		Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	30	0	0	0	0	0
Annual IC Time Burden (Hours)	30	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Flyer	QDRL OMB-10-day package Children's Mental Health Svs -Attach 1-011008.doc	01/10/2008

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