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NSCH "Healthy and Ready to Learn" Questions 2020 (Self-administered/English)
Collaborating Center for Questionnaire Design and Evaluation Research
OMB: 0920-0222
IC ID: 244069
OMB.report
HHS/CDC
OMB 0920-0222
ICR 201807-0920-004
IC 244069
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:
2022-12-21 - Revision of a currently approved collection
2021-08-16 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Att 1 Healthy&Ready 2Learn Questionnaire.docx
Other-WORD
Att 3ab Healthy&Ready 2Learn Telephone Screener.docx
Other-WORD
Att 2 Healthy&Ready 2Learn AdFlyer.docx
Other-WORD
Att 5ab Healthy&Ready 2Learn Respondent Data Collection Sheet.docx
Other-WORD
Att 7 Healthy&Ready 2Learn Follow-up Interview.docx
Other-WORD
0920-0222 10-day letter-HealthyReady 2Learn 9.28.2020.docx
10-Day Letter (Request for Approval)
IC Document
Att 4ab Healthy&Ready 2Learn Informed Consent.docx
Att 4ab Healthy&Ready 2Learn Informed Consent
IC Document
Att 6 Healthy&Ready 2Learn Thank You Letter.docx
Att 6 Healthy&Ready 2Learn Thank You Letter
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NSCH "Healthy and Ready to Learn" Questions 2020 (Self-administered/English)
Agency IC Tracking Number:
0920-0222-20SK
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
Other-WORD
Att 1 Healthy&Ready 2Learn Questionnaire.docx
Yes
Yes
Fillable Fileable
Other-WORD
Att 3ab Healthy&Ready 2Learn Telephone Screener.docx
No
Paper Only
Other-WORD
Att 2 Healthy&Ready 2Learn AdFlyer.docx
No
Paper Only
Other-WORD
Att 5ab Healthy&Ready 2Learn Respondent Data Collection Sheet.docx
No
Paper Only
Other-WORD
Att 7 Healthy&Ready 2Learn Follow-up Interview.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
305
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
305
0
305
0
0
0
Annual IC Time Burden (Hours)
93
0
93
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
10-Day Letter (Request for Approval)
0920-0222 10-day letter-HealthyReady 2Learn 9.28.2020.docx
10/14/2020
Att 4ab Healthy&Ready 2Learn Informed Consent
Att 4ab Healthy&Ready 2Learn Informed Consent.docx
10/14/2020
Att 6 Healthy&Ready 2Learn Thank You Letter
Att 6 Healthy&Ready 2Learn Thank You Letter.docx
10/14/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.