Information Collection

National Health and Nutrtion Examination Survey

IC 189814 under ICR 200901-0920-003 · OMB 0920-0237.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0237 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form unnumbered National Health and Nutrtion Examination Survey	Form
unnumbered Att. A. Dried Blood Spot Protocol NHANES 2009 Att A blood spot_v1.doc	Form
NHANES 2009 sup st_v1 change blood spot (4).doc Supporting Document	IC Document

IC Title:

National Health and Nutrtion Examination Survey

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	unnumbered	Att. A. Dried Blood Spot Protocol	NHANES 2009 Att A blood spot_v1.doc		Yes	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the US Population

FR Citation: 49 FR 37693

Number of Respondents: 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 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	400	0	0	0	0	0
Annual IC Time Burden (Hours)	33	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
Supporting Document	NHANES 2009 sup st_v1 change blood spot (4).doc	06/29/2009

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