Survey to Pathways to Diagnosis and Services and 2011 National Survey of Children's Health

State and Local Area Integrated Telephone Survey (SLAITS)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0406 can be found here:

Documents and Forms

Document Name Document Type
Survey to Pathways to Diagnosis and Services and 2011 National Survey of Children's Health Form
Survey to Pathways to Diagnosis and Treatment telephone Attach 2 SPDS teleph questnnaire 01_21_11.docx Form
Survey of Pathways to Diagnosis and Services mail questi Attach 3 SPDS mail questionnaire 01_21_11.docx Form
NSCH - telephone interview Attach 5 NSCH questnnaire 01_21_11.docx Form
Attach 4 SPDS expert panel 01_21_11.docx Survey of Pathways - expert panel IC Document
Attach 1 SPDS adv letters 01_21_11.docx Survey of Pathways - advance letters IC Document
2011 SPDS OMB 83C parts A_B 01_21_11.docx Survey of Pathways - supporting statement IC Document
2011 NSCH OMB 83C part A 01_21_11.docx NSCH - supporting statement IC Document
Attach 6 NSCH instrum rev summary 01_21_11.docx NSCH - summary of revisions for 2011 IC Document

Information Collection (IC) Details

IC Title:	Survey to Pathways to Diagnosis and Services and 2011 National Survey of Children's Health	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Survey of Pathways to Diagnosis and Services mail questionnaire	Attach 3 SPDS mail questionnaire 01_21_11.docx	No	No	Fillable Printable
Form	none	NSCH - telephone interview	Attach 5 NSCH questnnaire 01_21_11.docx	Yes	Yes	Fillable Fileable
Form	none	Survey to Pathways to Diagnosis and Treatment telephone interview	Attach 2 SPDS teleph questnnaire 01_21_11.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Health and Demographic Surveys Conducted in Probability Samples of the US Population	FR Citation: 49 FR 37637

Number of Respondents: 8,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	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	8,000	0	0	0	0	0
Annual IC Time Burden (Hours)	3,667	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Survey of Pathways - expert panel	Attach 4 SPDS expert panel 01_21_11.docx	01/27/2011
Survey of Pathways - advance letters	Attach 1 SPDS adv letters 01_21_11.docx	01/27/2011
Survey of Pathways - supporting statement	2011 SPDS OMB 83C parts A_B 01_21_11.docx	01/27/2011
NSCH - supporting statement	2011 NSCH OMB 83C part A 01_21_11.docx	01/27/2011
NSCH - summary of revisions for 2011	Attach 6 NSCH instrum rev summary 01_21_11.docx	01/27/2011

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