Household Screening

2011 National Survey on Drug Use and Health (NSDUH)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0110 can be found here:

Documents and Forms

Document Name Document Type
Form Survey Household Screening Form and Instruction
Survey Survey CAI.zip Form and Instruction
Survey Survey NSDUH_2010_CAI.zip Form and Instruction
Final Package Attachments.zip Attachments IC Document
NSDUH_2010_Screener.zip Screener IC Document
NSDUH_2010_attachments.zip Other Attachments IC Document
Attachment AA.doc List of Counties IC Document

Information Collection (IC) Details

IC Title:	Household Screening	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	Survey	Survey	CAI.zip		Yes	Yes	Paper Only
Form and Instruction	Survey	Survey	NSDUH_2010_CAI.zip		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 196,720	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	196,720	5,830	190,890
Annual IC Time Burden (Hours)	16,328	-69,638	85,966
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachments	Final Package Attachments.zip	06/24/2008
Screener	NSDUH_2010_Screener.zip	06/09/2009
Other Attachments	NSDUH_2010_attachments.zip	06/09/2009
List of Counties	Attachment AA.doc	11/15/2010

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