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Developmental Projects & Special Studies Testing
National Health and Nutrition Examination Survey
OMB: 0920-0950
IC ID: 245124
OMB.report
HHS/CDC
OMB 0920-0950
ICR 202209-0920-001
IC 245124
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0950 can be found here:
2024-10-17 - Revision of a currently approved collection
2023-03-09 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 0920-0950
Developmental Projects & Special Studies Testing
Form and Instruction
0920-0950 Introductory Letter for SP Questionnaire
Att_13a_Introductory Letter for SP Questionnaire_v6_201029.docx
Form and Instruction
0920-0950 NHANES Follow-Up Questionnaire
Att. 2 NHANES_Follow_up_Questionnaire_v9_04102022.pdf
Form and Instruction
0920-0950 NHANES Refuser No Show Questionnaire
Att. 4 NHANES_Refuser_No_Show_v8_04102022.pdf
Form and Instruction
Att. 1 MEC FollowUp_Letter_02242022.docx
MEC Follow-Up Letter
IC Document
Att. 3 MEC Refusers_Letter_02242022.docx
MEC Refuser Letter
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Developmental Projects & Special Studies Testing
Agency IC Tracking Number:
0920-05
Is this a Common Form?
No
IC Status:
Unchanged
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
0920-0950
Introductory Letter for SP Questionnaire
Att_13a_Introductory Letter for SP Questionnaire_v6_201029.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0950
NHANES Follow-Up Questionnaire
Att. 2 NHANES_Follow_up_Questionnaire_v9_04102022.pdf
NA
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0950
NHANES Refuser No Show Questionnaire
Att. 4 NHANES_Refuser_No_Show_v8_04102022.pdf
NA
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population
FR Citation:
49 FR 37693
Number of Respondents:
3,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
3,500
0
0
0
0
3,500
Annual IC Time Burden (Hours)
10,500
0
0
0
0
10,500
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
MEC Follow-Up Letter
Att. 1 MEC FollowUp_Letter_02242022.docx
05/18/2022
MEC Refuser Letter
Att. 3 MEC Refusers_Letter_02242022.docx
05/18/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.