NSCH Screener Cognitive Interviews

Generic Clearance for Questionnaire Pretesting Research

OMB: 0607-0725

IC ID: 233477

Documents and Forms
Document Name
Document Type
Form and Instructi
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

NSCH Screener Cognitive Interviews
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Screener Card Screener Card Content - 2 options_OMB.docx No   Fillable Fileable
Form and Instruction 2 Experimental Treatment B - NonPerforated Mockup 1 NSCH11wa - Experimental Treatment B_Non-perforated Mockup 1_OMB.docx No   Fillable Fileable
Form and Instruction 3 Experimental Treatment B - NonPerforated Mockup 2 NSCH11wa - Experimental Treatment B_Non-perforated Mockup 2_OMB.docx No   Fillable Fileable
Form and Instruction 4 Experimental Treatment B - Perforated Mockup 1 NSCH11wa - Experimental Treatment B_Perforated Mockup 1_OMB.docx No   Fillable Fileable
Form and Instruction 5 Experimental Treatment B - Perforated Mockup 2 NSCH11wa - Experimental Treatment B_Perforated Mockup 2_OMB.docx No   Fillable Fileable
Form and Instruction 6 Experimental Treatment C NSCH11wa - Experimental Treatment C_OMB.docx No   Fillable Fileable
Form and Instruction 7 Standard Treatments A and D NSCH11wa - Standard Version (Treatments A and D)_OMB.docx No   Fillable Fileable
Form and Instruction 8 NonPerforated Mockup 1 NSCH12wa - Non-perforated Mockup 1_OMB.docx No   Fillable Fileable
Form and Instruction 9 NonPerforated Mockup 2 NSCH12wa - Non-perforated Mockup 2_OMB.docx No   Fillable Fileable
Form and Instruction 10 Perforated Mockup 1 NSCH12wa - Perforated Mockup 1_OMB.docx No   Fillable Fileable
Form and Instruction 11 Perforated Mockup 2 NSCH12wa - Perforated Mockup 2_OMB.docx 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
OMB Memo OMB letter - NSCH Screener cognitive interviewing_OMB (2).docx 10/11/2018
Protocol NSCH Screener Cognitive Interviewing Protocol _OMB.docx 10/11/2018
Screener Participant Screener_NSCH Screener Card_OMB (2).docx 10/11/2018
Consent Form NSCH Screener Consent Form_OMB.doc 10/11/2018
Voucher NSCH Screener Voucher_OMB.docx 10/11/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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