Cognitive Testing of 2021 Occupational Health Supplement Questions

Collaborating Center for Questionnaire Design and Evaluation Research

OMB: 0920-0222

IC ID: 240112

Information Collection (IC) Details

View Information Collection (IC)

Cognitive Testing of 2021 Occupational Health Supplement Questions 0920-0222-20KP
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0222 Questions for Consideration NHIS-OHS 2021 Supplement Att 2 - Questionnaire-2-24-2020.docx No   Fillable Fileable
Instruction Att 4ab - NIOSH telephone screener 020420-lc.docx No   Printable Only
Form 0920-0222 Respondent Data Collection Sheet Att 6 - NIOSH Resp Data Collect Sheet.docx No   Fillable Fileable

Health Public Health Monitoring

Health and Demographic Surveys Conducted in Probability Samples of the U. S. Population 09-20-0164  49 FR 37693

75 0
   
Individuals or Households
 
   0 %

  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 75 0 75 0 0 0
Annual IC Time Burden (Hours) 23 0 23 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
10-day Letter 10-day letter_NIOSH_12-11-2020_REVISED-2-24-2020-CLEAN.docx 02/26/2020
NIOSH Res[ponse to Questions Raised by OMB Att 1 - NIOSH Response to Qs 11-12-2019-REVISED-2-24-2020- CLEAN.docx 02/26/2020
Att 3a Semi-targeted Advertisement Att 3ab - NIOSH Ad&Flyer.docx 02/26/2020
Att 5_Adult Informed Consernt Form for One-on-One Interviews Att 5 - NIOSH informed consent 1121 2019-kw--1-9-2020-CLEAN.docx 02/26/2020
Att 7_Thank you letter Att 7 - NIOSH Thank You Letter-1121 2019.docx 02/26/2020
Att 8_Special Consent for Expanded Use of Video and Audio Recordings Att 8 - NIOSH Special Consent.docx 02/26/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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