Information Collection

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

IC 239376 under ICR 201807-0920-004 · OMB 0920-0222.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

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

Agency IC Tracking Number:

0920-20GK

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.