Household Screening

2013 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⚠️ Notice: This information collection may be referencing outdated material.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 Screening Question Household Screening Form and Instruction
Screening Question Screening Questions PDF 3 - Attachment H.pdf Form and Instruction
PDF 1 - Attachments A,C,D,E,L.pdf Attachments A,C,D,E,L IC Document
PDF 4 - Attachments I,J.pdf Attachments I,J IC Document
PDF 5 - Attachment K.pdf Attachment K IC Document
PDF 6 - Attachments M,N,O.pdf Attachments M,N,O IC Document
PDF 7 - Attachments P,Q.pdf Attachments P,Q IC Document
PDF 8 - Attachments F,G,R.pdf Attachments F,G,R IC Document
PDF 9 - Attachment S.pdf Attachment S IC Document
Attachment T_1.pdf Comment IC Document
Attachment T_2.pdf Response 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	Screening Questions	Screening Questions	PDF 3 - Attachment H.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 145,474	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	145,474	-45,626	191,100
Annual IC Time Burden (Hours)	12,074	-3,787	15,861
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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