Parent Survey Consent

Att 6 NAHS AmeriSpeak Parent Survey Consent_final.docx

Teen and Parent Surveys of Health (TAPS)

Parent Survey Consent

OMB: 0920-1362

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National Adolescent Health Survey parent/caregiver consent via NORC’s AmeriSpeak panel



We are asking you to take part in this survey on a series of topics about your teen, including their mental health, sexual and reproductive health, social support systems, and school environment. This will take you about 15 minutes to finish, depending on your answers.

Important things you should know are:

  • The National Adolescent Health Survey is being conducted by NORC on behalf of the U.S. Centers for Disease Control and Prevention’s (CDC) Division of Adolescent and School Health.

  • All questions are voluntary and you can skip questions if you wish.

  • We would encourage you to take the survey at any time when you have privacy.

  • You will be compensated for your time via cash-equivalent of $20 for completing the survey.


If you have any questions or concerns about your participation in this study, you can contact AmeriSpeak Support at [email protected] or call (888) 326-9424.

Would you be willing to complete this survey?


  1. Yes

  2. No



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorStephanie Jwo
File Modified0000-00-00
File Created2021-10-20

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