National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA)

State and Local Area Integrated Telephone Survey (SLAITS)

Documents and Forms

Document Name Document Type
National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA) Form
2014 NS-DATA Telephone Questionnaire OMB_Attachment A.docx Form
NS-DATA OMB Part B 11_25_13.docx Supporting Statement B IC Document
NS-DATA OMB Part A 11_25_13.docx Supporting Statement A IC Document
OMB_Attachment B 1125.docx B - Letters IC Document
OMB_Attachment C 110713.docx C - Publications IC Document
OMB_Attachment D.docx D - Persons involved in process IC Document
OMB_Attachment E.docx E - Introductory scripts IC Document
Attachment G SLAITS IRB Approval.pdf IRB approval IC Document
OMB Attachment F NS-DATA 30-day 110113.pdf F - 30 day FRN IC Document

Information Collection (IC) Details

IC Title:	National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA)	Agency IC Tracking Number:

IC Status: New

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	none	2014 NS-DATA Telephone Questionnaire	OMB_Attachment A.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

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: 3,700	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	3,700	0	0	0	0	0
Annual IC Time Burden (Hours)	1,850	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement B	NS-DATA OMB Part B 11_25_13.docx	11/25/2013
Supporting Statement A	NS-DATA OMB Part A 11_25_13.docx	11/25/2013
B - Letters	OMB_Attachment B 1125.docx	11/25/2013
C - Publications	OMB_Attachment C 110713.docx	11/25/2013
D - Persons involved in process	OMB_Attachment D.docx	11/25/2013
E - Introductory scripts	OMB_Attachment E.docx	11/25/2013
IRB approval	Attachment G SLAITS IRB Approval.pdf	11/25/2013
F - 30 day FRN	OMB Attachment F NS-DATA 30-day 110113.pdf	11/25/2013

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