Screener

National Health and Nutrition Examination Survey

OMB: 0920-0950

IC ID: 233000

Information Collection (IC) Details

View Information Collection (IC)

Screener
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Screener and Non-response Bias Module Att_3b_Screener Instrument rev 102318.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

Health and Demographic Surveys Conducted in Probablity Samples of the US Population  49 FR 37693

15,000 0
   
Individuals or Households
 
   100 %

  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 15,000 0 15,000 0 0 0
Annual IC Time Burden (Hours) 1,250 0 1,250 0 0 0
Annual IC Cost Burden (Dollars) 29,850 0 29,850 0 0 0

Title Document Date Uploaded
Screener Hand Cards Att_3c_Screener Handcards_5_7_2018.docx 09/13/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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