National Health and Nutrition Examination Survey (NHANES – Growth Chart)

Collaborating Center for Questionnaire Design and Evaluation Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:

Documents and Forms

Document Name Document Type
National Health and Nutrition Examination Survey (NHANES – Growth Chart) Form and Instruction
Focus Group Protocol (NHANES Growth Chart) Att 1- NHANES Growth Chart Protocol.docx Form and Instruction
Data Collection Sheet (participant demographics) Att 3- NHANES Growth Chart Data Collection Sheet.docx Form and Instruction
10 Day Letter - NHANES Growth Chart 1.17.2020.docx Project Justification and Description IC Document
Att 2- NHANES Growth Chart Informed Consent.docx Informed Consent IC Document
Att 4- NHANES Growth Chart Thank You Letter.docx Thank You Letter to Participants IC Document

Information Collection (IC) Details

IC Title:	National Health and Nutrition Examination Survey (NHANES – Growth Chart)	Agency IC Tracking Number:	0920-20GK

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	n/a	Focus Group Protocol (NHANES Growth Chart)	Att 1- NHANES Growth Chart Protocol.docx		No		Paper Only
Form and Instruction	n/a	Data Collection Sheet (participant demographics)	Att 3- NHANES Growth Chart Data Collection Sheet.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Health and Demographic Surveys Conducted in Probability Samples of the U. S. Population 09-20-0164	FR Citation: 49 FR 37693

Number of Respondents: 40	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	40	40
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Project Justification and Description	10 Day Letter - NHANES Growth Chart 1.17.2020.docx	01/22/2020
Informed Consent	Att 2- NHANES Growth Chart Informed Consent.docx	01/22/2020
Thank You Letter to Participants	Att 4- NHANES Growth Chart Thank You Letter.docx	01/22/2020

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