2017-2019 Youth Risk Behavior Survey

2017 and 2019 Youth Risk Behavior Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0493 can be found here:

Documents and Forms

Document Name Document Type
2017-2019 Youth Risk Behavior Survey Form and Instruction
Youth Risk Behavior Questionnaire 2017 - 2019 App J_YRB Survey Questionnaire.docx Form and Instruction
Appx D - Rationale for Survey Questions.docx Appx D - Rationale for Survey Questions IC Document
Appx F - YRBS Questionnaire - supplemental documents.doc Appx F - YRBS Questionnaire - supplemental documents IC Document

Information Collection (IC) Details

IC Title:	2017-2019 Youth Risk Behavior Survey	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	NA	Youth Risk Behavior Questionnaire 2017 - 2019	App J_YRB Survey Questionnaire.docx	NA	No		Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10,129	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10,129	10,129
Annual IC Time Burden (Hours)	7,597	7,597
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appx D - Rationale for Survey Questions	Appx D - Rationale for Survey Questions.docx	07/16/2012
Appx F - YRBS Questionnaire - supplemental documents	Appx F - YRBS Questionnaire - supplemental documents.doc	07/16/2012

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