NSCH Questionnaire Cognitive Testing

Generic Clearance for Questionnaire Pretesting Research

OMB: 0607-0725

IC ID: 227344

Information Collection (IC) Details

View Information Collection (IC)

NSCH Questionnaire Cognitive Testing
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 English Screener NSCH S1_Cognitive Interviewing Version.pdf No   Fillable Fileable
Form and Instruction 2 English Topical Questionnaire 1 NSCH T1_Cognitive Interviewing Version.pdf No   Fillable Fileable
Form and Instruction 3 English Topical Questionnaire 2 NSCH T2_Cognitive Interviewing Version.pdf No   Fillable Fileable
Form and Instruction 4 English Topical Questionnaire 3 NSCH T3_Cognitive Interviewing Version.pdf No   Fillable Fileable
Form and Instruction 5 Spanish Screener NSCH S1(S)_Cognitive Interviewing Version (2).pdf No   Fillable Fileable
Form and Instruction 6 Spanish Topical Questionnaire 1 NSCH T1(S)_Cognitive Interviewing Version (3).pdf No   Fillable Fileable
Form and Instruction 7 Spanish Topical Questionnaire 2 NSCH T2(S)_Cognitive Interviewing Version (4).pdf No   Fillable Fileable
Form and Instruction 8 Spanish Topical Questionnaire 3 NSCH T3(S)_Cognitive Interviewing Version (1).pdf No   Fillable Fileable

General Government Central Records & Statistical Mgt

 

30 0
   
Individuals or Households
 
   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 30 0 30 0 0 0
Annual IC Time Burden (Hours) 36 0 36 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Recruitment Screener Screener_NSCH Questionnaire redesign.docx 06/30/2017
Consent Form Consent forms for Demographic Surveys_NSCH.doc 06/30/2017
Voucher Form voucher_NSCH.docx 06/30/2017
Protocol NSCH Cognitive Interviewing Protocol_OMB.docx 06/30/2017
OMB Memo OMB letter - NSCH cognitive interviewing.docx 06/30/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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