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YRBS Questionnaire
National Youth Risk Behavior Survey Test-Retest Reliability Study
OMB: 0920-1334
IC ID: 244892
OMB.report
HHS/CDC
OMB 0920-1334
ICR 202012-0920-007
IC 244892
( )
Documents and Forms
Document Name
Document Type
Form 0920-
YRBS Questionnaire
Form and Instruction
0920- 2021 National Youth Risk Behavior Survey
Att C-2021 National YRBS Questionnaire.docx
Form and Instruction
0920- 2021 National Youth Risk Behavior Survey
Att C-2021 National YRBS Questionnaire.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
YRBS Questionnaire
Agency IC Tracking Number:
0920-20OJ
Is this a Common Form?
No
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
0920-
2021 National Youth Risk Behavior Survey
Att C-2021 National YRBS Questionnaire.docx
Yes
Yes
Fillable Fileable
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:
1,000
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
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
2,000
0
2,000
0
0
0
Annual IC Time Burden (Hours)
1,500
0
1,500
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.