Information Collection

2018 NSCH Usability Evaluation

IC 230290 under ICR 201606-0607-003 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Questionnaire V1 2018 NSCH Usability Evaluation	Form and Instruction
Form 2 Questionnaire V2 2018 NSCH Usability Evaluation	Form and Instruction
Form 3 Questionnaire V3 2018 NSCH Usability Evaluation	Form and Instruction
Form 4 Questionnaire V4 2018 NSCH Usability Evaluation	Form and Instruction
Form 5 Demographic Questionnaire 2018 NSCH Usability Evaluation	Form and Instruction
Form 6 Satisfaction Questionnaire 2018 NSCH Usability Evaluation	Form and Instruction
1 Questionnaire V1 Enclosure 6S nschs1_18_021218.pdf	Form and Instruction
2 Questionnaire V2 Enclosure 6T1 nscht1_18_020818.pdf	Form and Instruction
3 Questionnaire V3 Enclosure 6T2 nscht2_18_020818.pdf	Form and Instruction
4 Questionnaire V4 Enclosure 6T3 nscht3_18_020818.pdf	Form and Instruction
5 Demographic Questionnaire Enclosure 2 Demographics.docx	Form and Instruction
6 Satisfaction Questionnaire Enclosure 4 Satisfaction questionnaire.docx	Form and Instruction
OMB letter - NSCH_Final_V2_3_23_2018.docx OMB Memo	IC Document
Enclosure 1 2018 NSCH Protocol_Final.docx Protocol	IC Document
Enclosure 3 Debriefing Slides.pptx Debriefing Slides	IC Document
Enclosure 5 Screener_NSCH Questionnaire redesign.docx Recruiting Documents	IC Document

IC Title:

2018 NSCH Usability Evaluation

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Electronic Capability
Form and Instruction	1	No	Fillable Fileable
Form and Instruction	2	No	Fillable Fileable
Form and Instruction	3	No	Fillable Fileable
Form and Instruction	4	No	Fillable Fileable
Form and Instruction	5	No	Fillable Fileable
Form and Instruction	6	No	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 18

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	18	18
Annual IC Time Burden (Hours)	34	34
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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