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National Survey of Children's Health
National Survey of Children's Health
OMB: 0607-0990
IC ID: 220525
OMB.report
DOC/CENSUS
OMB 0607-0990
ICR 201611-0607-002
IC 220525
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0990 can be found here:
2024-03-20 - Revision of a currently approved collection
2023-03-10 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form NSCH-S1
National Survey of Children's Health
Form and Instruction
NSCH-S1 NSCH Screener - English
NSCH_S1_FINAL.pdf
Form and Instruction
NSCH-PS-S1 NSCH Screener - Spanish
NSCH_PS-S1 FINAL.pdf
Form and Instruction
NSCH-PS-T1 NSCH Topical 1 (0-5) - Spanish
NSCH_PS-T1 FINAL.pdf
Form and Instruction
NSCH-PS-T2 NSCH Topical 2 (6-11) - Spanish
NSCH_PS-T2 FINAL.pdf
Form and Instruction
NSCH-PS-T3 NSCH Topical 3 (12-17) - Spanish
NSCH_PS-T3 FINAL.pdf
Form and Instruction
NSCH-T1 NSCH Topical 1 (0-5) - English
NSCH_T1_FINAL.pdf
Form and Instruction
NSCH-T2 NSCH Topical 2 (6-11) - English
NSCH_T2_FINAL.pdf
Form and Instruction
NSCH-T3 NSCH Topical 3 (12-17) - English
NSCH_T3_FINAL.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Survey of Children's Health
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
NSCH-S1
NSCH Screener - English
NSCH_S1_FINAL.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
NSCH-PS-S1
NSCH Screener - Spanish
NSCH_PS-S1 FINAL.pdf
Yes
Yes
Fillable Printable
Form and Instruction
NSCH-PS-T1
NSCH Topical 1 (0-5) - Spanish
NSCH_PS-T1 FINAL.pdf
Yes
Yes
Fillable Printable
Form and Instruction
NSCH-PS-T2
NSCH Topical 2 (6-11) - Spanish
NSCH_PS-T2 FINAL.pdf
Yes
Yes
Fillable Printable
Form and Instruction
NSCH-PS-T3
NSCH Topical 3 (12-17) - Spanish
NSCH_PS-T3 FINAL.pdf
Yes
Yes
Fillable Printable
Form and Instruction
NSCH-T1
NSCH Topical 1 (0-5) - English
NSCH_T1_FINAL.pdf
Yes
Yes
Fillable Printable
Form and Instruction
NSCH-T2
NSCH Topical 2 (6-11) - English
NSCH_T2_FINAL.pdf
Yes
Yes
Fillable Printable
Form and Instruction
NSCH-T3
NSCH Topical 3 (12-17) - English
NSCH_T3_FINAL.pdf
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
SORN Census 3
FR Citation:
77 FR 18205
Number of Respondents:
266,906
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
45 %
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
266,906
0
0
0
0
266,906
Annual IC Time Burden (Hours)
54,117
0
0
0
0
54,117
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.