OMB
.report
Search
Clinical Follow-up Interview
2012 National Survey on Drug Use and Health (NSDUH)
OMB: 0930-0110
IC ID: 195360
OMB.report
HHS/SAMHSA
OMB 0930-0110
ICR 201107-0930-002
IC 195360
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0110 can be found here:
2024-08-15 - Revision of a currently approved collection
2024-04-09 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
No instruments[2].doc
Instruction
PDF 10 - Attachment T,U .pdf
Attachment T,U
IC Document
PDF 11 - Attachment V.pdf
Attachment V
IC Document
PDF 12 - Attachment W, X, Y, Z .pdf
Attachment W, X, Y, Z
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Clinical Follow-up Interview
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
Instruction
No instruments[2].doc
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,500
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
1,500
0
0
0
0
1,500
Annual IC Time Burden (Hours)
1,500
0
0
0
0
1,500
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment T,U
PDF 10 - Attachment T,U .pdf
06/23/2011
Attachment V
PDF 11 - Attachment V.pdf
06/23/2011
Attachment W, X, Y, Z
PDF 12 - Attachment W, X, Y, Z .pdf
06/23/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.