Parent Interview

National Mental Health Study (NMHS) Field Test

Documents and Forms

Document Name Document Type
Form Parent Questionnai Parent Interview Form and Instruction
Parent Questionnai Parent Questionnaire NMHS OMB_PDF 03.pdf Form and Instruction
NMHS OMB_PDF 10.pdf Parent Materials IC Document

Information Collection (IC) Details

IC Title:	Parent Interview	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	Parent Questionnaire	Parent Questionnaire	NMHS OMB_PDF 03.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 210	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	210	210
Annual IC Time Burden (Hours)	105	105
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Parent Materials	NMHS OMB_PDF 10.pdf	07/10/2017

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