Information Collection

Pre-School Psychiatric Assessment Calibration of the Short Strengths and Difficulties Questionnaire (SDQ) in the National Health Interview Survey (NHIS) - line 1

IC 196123 under ICR 201102-0920-008 · OMB 0920-0884.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Pre-School Psychiatric Assessment Calibration of the Short Strengths and Difficulties Questionnaire (SDQ) in the National Health Interview Survey (NHIS) - line 1	Form
1 The Electronic Pre-School Psychiatric Assessment Att C 1 PAPA pp C0 C40.pdf	Form
2 Pre-School Psychiatric Assessment Att C 2 PAPA pp C41 - C90.pdf	Form and Instruction
3 Pre-School Psychiatric Assessment Att C 3 PAPA pp C91 - C149.pdf	Form and Instruction
4 Pre-School Psychiatric Assessment Att C 4 PAPA pp C150 - C199.pdf	Form and Instruction
5 Pre-School Psychiatric Assessment Att C 5 PAPA pp C200 - C250.pdf	Form and Instruction
6 Pre-School Psychiatric Assessment Att C 6 PAPA pp C251 - C300.pdf	Form and Instruction
7 Pre-School Psychiatric Assessment Att C 7 PAPA pp C301 C316.pdf	Form and Instruction
Att C PAPA OMB Statement and Screener.doc Att C PAPA OMB Statement and Screener	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Pre-School Psychiatric Assessment Calibration of the Short Strengths and Difficulties Questionnaire (SDQ) in the National Health Interview Survey (NHIS) - line 1

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	The Electronic Pre-School Psychiatric Assessment	Att C 1 PAPA pp C0 C40.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	2	Pre-School Psychiatric Assessment	Att C 2 PAPA pp C41 - C90.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	3	Pre-School Psychiatric Assessment	Att C 3 PAPA pp C91 - C149.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	4	Pre-School Psychiatric Assessment	Att C 4 PAPA pp C150 - C199.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	5	Pre-School Psychiatric Assessment	Att C 5 PAPA pp C200 - C250.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	6	Pre-School Psychiatric Assessment	Att C 6 PAPA pp C251 - C300.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	7	Pre-School Psychiatric Assessment	Att C 7 PAPA pp C301 C316.pdf	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

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 U. S. Population

FR Citation: 49 FR 37693

Number of Respondents: 63

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	63	63
Annual IC Time Burden (Hours)	63	63
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att C PAPA OMB Statement and Screener	Att C PAPA OMB Statement and Screener.doc	02/04/2011

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