Cognitive Testing of NHIS health care utilization smoking, and selected child questions

NCHS Questionnaire Design Research Laboratory

OMB: 0920-0222

IC ID: 227302

Information Collection (IC) Details

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Cognitive Testing of NHIS health care utilization smoking, and selected child questions 0920-17AUC
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 092017AUC Attach 3 Telephone Screener vcb 051017kw no confid pld update Attach 3 Telephone Screener vcb 051017kw no confid pld update.docx Yes Yes Fillable Fileable
Form and Instruction 0920-17AUC Attach 3 Telephone Screener vcb 051017kw no confid pld update Attach 5 Resp Data Collect Sheet.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

Health and Demographic Surveys Conducted in Probability Samples of the U. S. Population 09-20-0164   49 FR 37693

112 0
   
Individuals or Households
 
   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 112 0 112 0 0 0
Annual IC Time Burden (Hours) 46 0 46 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
10-day letter HIS Redesign 0626 2017 10-day letter HIS Redesign 0626 2017.docx 06/27/2017
Attach 1 HIS Redesign Qnne vcb 051017kw no confid pledge change Attach 1 HIS Redesign Qnne vcb 051017kw no confid pledge change.docx 06/27/2017
Attach 2a&b Adv&Flyer Attach 2a&b Adv&Flyer.docx 06/27/2017
Attach 4 Informed Consent vcb 051017kw no confid pled update Attach 4 Informed Consent vcb 051017kw no confid pled update.docx 06/27/2017
C C.docx 06/27/2017
Attach 6 Thank You Letter Attach 6 Thank You Letter.docx 06/27/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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