Information Collection

National Survey of Children's Health

IC 220525 under ICR 201712-0607-002 · OMB 0607-0990.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0990 can be found here:

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-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
NSCH-S-S1 NSCH-Screener - Spanish NSCH-S-S1_FINAL.pdf Form and Instruction
NSCH-S-T1 NSCH Topical 1 (0-5) - Spanish NSCH-S-T1_FINAL.pdf Form and Instruction
NSCH-S-T2 NSCH Topical 2 (6-11) - Spanish NSCH-S-T2_FINAL.pdf Form and Instruction
NSCH-S-T3 NSCH Topical 3 (12-17) - Spanish NSCH-S-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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NSCH-S1	NSCH-Screener - English	NSCH_S1_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
Form and Instruction	NSCH-S-S1	NSCH-Screener - Spanish	NSCH-S-S1_FINAL.pdf	Yes	Yes	Fillable Printable
Form and Instruction	NSCH-S-T1	NSCH Topical 1 (0-5) - Spanish	NSCH-S-T1_FINAL.pdf	Yes	Yes	Fillable Printable
Form and Instruction	NSCH-S-T2	NSCH Topical 2 (6-11) - Spanish	NSCH-S-T2_FINAL.pdf	Yes	Yes	Fillable Printable
Form and Instruction	NSCH-S-T3	NSCH Topical 3 (12-17) - Spanish	NSCH-S-T3_FINAL.pdf	Yes	Yes	Fillable Printable

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	Previously Approved
Annual Number of Responses for this IC	266,906	266,906
Annual IC Time Burden (Hours)	16,573	16,573
Annual IC Cost Burden (Dollars)	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.