National Survey of Psychiatrists Cognitive Testing

Generic Clearance for Questionnaire Pretesting Research

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 1 National Survey of Psychiatrists Cognitive Testing Form and Instructi
1 Questionnaire NSP-1_111418_D20.pdf Form and Instruction
2 Alternative Full page Coversheet w/ Questionnaire (begin NSP-1_110618_v2.pdf Form and Instruction
3 Alternative Cover Image 1 cover2.pdf Form and Instruction
4 Alternative Cover Image 2 cover3.pdf Form and Instruction
Screener_NSP Questionnaire redesign.docx Screener IC Document
Consent forms for Demographic Surveys_NSP.doc Consent Form IC Document
NSP Cognitive Interviewing Protocol_Updated 11.16.18.docx Protocol IC Document
OMB letter - NSP cognitive interviewing_Updated 11.16.18.docx OMB Memo IC Document

Information Collection (IC) Details

IC Title:	National Survey of Psychiatrists Cognitive Testing	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	1	Questionnaire	NSP-1_111418_D20.pdf	No	Fillable Fileable
Form and Instruction	2	Alternative Full page Coversheet w/ Questionnaire (beginning)	NSP-1_110618_v2.pdf	No	Fillable Fileable
Form and Instruction	3	Alternative Cover Image 1	cover2.pdf	No	Fillable Fileable
Form and Instruction	4	Alternative Cover Image 2	cover3.pdf	No	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	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	30	30
Annual IC Time Burden (Hours)	36	36
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Screener	Screener_NSP Questionnaire redesign.docx	11/16/2018
Consent Form	Consent forms for Demographic Surveys_NSP.doc	11/16/2018
Protocol	NSP Cognitive Interviewing Protocol_Updated 11.16.18.docx	11/16/2018
OMB Memo	OMB letter - NSP cognitive interviewing_Updated 11.16.18.docx	11/16/2018

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